对比脉冲序列超声造影成像分析脂肪肝内相对正常肝区

目的应用超声造影分析脂肪肝内相对正常肝区(FFS)与其周围脂肪肝是否存在血流灌注的差异。方法应用低机械指数对比脉冲序列成像对比分析52例63个脂肪肝内相对正常肝区与其周围脂肪肝的常规超声回声强度、定量分析不同时间点的超声造影增强强度。结果脂肪肝内相对正常肝区较其周边脂肪肝常规超声视频强度低,超声造影30,60,120 s增强强度较周围脂肪肝高(P<0.05)。应用超声造影后诊断FFS的敏感性、精确性从63.5%、82.5%分别提高到98.4%,98.6%。结论脂肪肝内相对正常肝区与周围脂肪肝可存在血流灌注的差异,超声造影提高了脂肪肝内FFS的诊断能力。     

实时灰阶谐波超声造影在肝肿瘤诊断中的应用

目的 研究实时灰阶谐波超声造影在肝肿瘤诊断中的价值.方法 对89例共101个肝内病灶进行实时灰阶谐波超声造影检查,其中原发性肝癌36例38个病灶,转移性肝癌24例32个病灶,肝血管瘤16例18个病灶,肝脓肿2例,硬化结节5例,局灶性结节性增生2例,肝腺瘤1例,局灶性脂肪肝3例.选用低机械指数成像技术GE Logiq 9超声诊断仪和Bracco公司的SonoVue超声造影剂.结果 注入造影剂后,实时谐波超声造影能显示不同肝肿瘤的造影特点,并能显示肿瘤的血流灌注信号.超声造影正确诊断肝癌和肝良性肿瘤病灶分别为67个(95.7%)和29个(93.5%).其诊断肝癌的敏感性、特异性及准确性分别为95.7%、93.5%、95.0%.结论 实时灰阶谐波超声造影能反映不同肝肿瘤增强模式及血流动力学变化,可帮助提高肝肿瘤超声诊断的准确性.     

实时灰阶谐波超声造影在肝肿瘤中的应用

目的 研究实时灰阶谐波超声造影在肝肿瘤诊断中的价值。方法 对89例共101个肝内占位病灶进行实时灰阶谐波超声造影检查,其中原发性肝癌36例38个病灶,转移性肝癌24例32个病灶,肝血管瘤16例18个病灶,肝脓肿2例,硬化结节5例,局灶性结节性增生2例,肝腺瘤1例,局灶性脂肪肝3例。选用低机械指数成像技术GE Logiq 9超声诊断仪和Bracco公司的SonoVue超声造影剂。结果 注入造影剂后,实时谐波超声造影能显示不同肝肿瘤的造影特点,并能显示肿瘤的血流灌注信号。超声造影正确诊断肝癌和肝良性肿瘤病灶分别为67个（/70）和29个（/31）。其诊断肝癌的敏感性、特异性及准确性分别为95.7%、93.5%、95%。结论 实时灰阶谐波超声造影能反映不同肝肿瘤增强模式及血流动力学变化,可帮助提高肝肿瘤超声诊断的准确性。     

肝静脉及下腔静脉灰阶超声造影的实验研究

目的应用低机械指数灰阶超声造影研究肝静脉和肝段下腔静脉的动态增强变化规律及其诊断价值。方法分别经耳缘静脉对13只正常和16只荷VX2瘤新西兰大白兔团注超声造影剂SonoVueTM（0.1?mL/kg）,应用CnTi(contrast tuned imaging)低机械指数实时造影匹配成像技术,动态观察兔肝静脉和肝段下腔静脉造影增强效应,并应用声学定量时间强度曲线分析(Wash in/Wash out)软件,定量分析8只正常兔下腔静脉造影增强效果。结果在所有造影过程中,肝段下腔静脉和第二肝门处肝静脉内造影剂均随时间延长呈动态增强。在早期从右心房反流来的造影剂,增强明显,是其增强的主要来源,与周围肝组织灰阶对比显著,是观察肝段下腔静脉和肝静脉病变的最佳时期。其开始增强时间和峰值时间均明显提前于肝实质,分别是6.4?s和13.5?s,与肝实质相比,两者差异具有统计学意义（P＜0.001）。随后造影剂逐渐退出,而肝实质逐渐增强,此时下腔静脉和肝静脉增强不明显。后期少量来源于经肝循环的造影剂进入下腔静脉及肝静脉,但增强效果轻微,与周围肝实质灰阶差别不明显,对下腔静脉和肝静脉疾病诊断意义不大。结论低机械指数灰阶超声造影技术能很好的对下腔静脉和肝静脉进行造影,对其疾病有一定的诊断意义。     

SonoVueTM低机械指数超声造影对肝肿瘤坏死的诊断价值

目的   应用SonoVueTM低机械指数灰阶超声造影研究肝肿瘤坏死的声像特点及其临床意义。 方法    将制备成功的16只荷VX2瘤新西兰大白兔随机分成A、B两组,分别于种植后10~12d（A组）、18~20d（B组）行低机械指数灰阶超声造影。经兔耳缘静脉团注超声造影剂SonoVueTM（0.1mL/kg）,应用CnTi（Contrast Tuned Imaging）低机械指数实时造影匹配成像技术,分析肝肿瘤坏死前后的造影增强效应。结果    低机械指数灰阶超声造影可动态显示肝实质与肿瘤内造影剂的增强过程。与正常肝实质相比较,A组肿瘤强化呈典型的“快进快出”型,即动脉早期快速增强,门脉期与延迟期肿瘤结节内造影剂迅速廓清,表现为负性显影;B组肿瘤增强过程与A组相似,但由于瘤内有不同程度坏死,仅显示周边环状增强,而中心坏死部位无论在动脉期、门脉期及延迟期均无强化,无强化区域与病理的液化坏死区域对应一致。结论    低机械指数灰阶超声造影可准确显示肿瘤的坏死范围,为其应用于评价肝癌局部治疗的疗效奠定了理论基础。     

肝脏局灶性炎性病变的灰阶超声及超声造影图像特征

目的：探讨灰阶超声及超声造影在肝脏局灶性炎性病变临床诊断中的应用价值。方法：回顾性分析33例肝脏局灶性炎性病变的灰阶超声及超声造影的图像特征,其中16例与病理结果进行比较。结果：33个炎性病灶的灰阶超声表现：形态规则15个,不规则18个;边界清晰21个,不清晰12个;内部可见液化区5个,无明显液化区28个;有占位效应13个,无明显占位效应20个。超声造影特征表现：病灶动脉期呈周边环状增强25个;内部可见分隔增强16个;肝段增强14个。延迟期呈低增强15个,同时伴形态不规则11个、无占位效应10个。结论：结合超声造影与灰阶超声图像特征有助于提高肝脏局灶性炎性病变诊断的准确性。     

不同肝背景下原发性肝癌超声造影灌注特征的定量分析

目的: 探讨正常肝、肝硬化及脂肪肝背景下原发性肝癌的超声造影表现,定量分析3种肝背景下原发性肝癌的血流灌注特征。 方法: 选择137例原发性肝癌患者共137个原发病灶,依据肝背景不同分为正常肝背景组(45例)、肝硬化背景组(51例)和脂肪肝背景组(41例)。观察3种肝背景下病灶的超声造影特征;应用时间-强度曲线分析3种肝背景组原发性肝癌的灌注参数,包括始增时间、达峰时间、峰值强度、梯度和灌注期曲线下面积。 结果: 本组137个病灶均表现为动脉相快速高增强,绝大多数病灶表现为典型的"快进快退"增强模式;但在正常肝背景组有6.7%、肝硬化背景组有31.4%的病灶表现为门脉相和延迟相呈等增强,甚至部分病灶内出现局部高增强的表现,即呈"快进慢退"增强模式;时间-强度曲线分析,3组肝背景下任2组病灶的始增时间、达峰时间、峰值强度、梯度及灌注期曲线下面积比较差异均无统计学意义 (P>0.05)。 结论: 3种肝背景下原发性肝癌的超声造影表现存在差异,但灌注参数无明显差异,应用时间-强度曲线能够客观准确地分析原发性肝癌超声造影的灌注参数,对病灶做出正确诊断。     

肝转移癌的超声造影表现及其临床应用价值

目的观察肝转移癌超声造影表现并探讨其临床应用价值。方法采用低机械指数实时灰阶谐波反相超声造影技术对21例共21个肝转移癌病灶进行超声造影,分析研究其造影增强各时相的特征。结果21个肝转移癌中,19个(90.5%)超声造影表现为快进快出,动脉相21个病灶均可见增强,12个(57.1%)为快速弥漫增强,8个(38.1%)为快速环状增强,余1个较大的病灶呈缓慢不均匀轻度增强;延迟相20个病灶(95.2%)呈边界清晰的低回声,3个(14.3%)发现更多的肝内病灶。结论肝转移癌的超声造影有特征性表现,可将其作为筛查及诊断的可靠依据。     

低机械指数谐波超声造影对肝癌介入治疗的疗效评估

目的探讨低机械指数谐波超声造影对肝癌介入治疗中对疗效的评估价值。方法对120例介入治疗的HCC患者分别于治疗前后逆行了低机械指数谐波超声造影、常规二维灰阶超声（2D）、彩色多普勒血流显像（CDFI）和增强CT／MR检查。记录病灶数目、大小，观察病灶内血供。结果120例患者介入治疗前2D及CDFT共检出病灶107个，超声造影共检出病灶121个；治疗前后超声造影显示病灶范围均较2D所示增大；病灶内血流信号检测以超声造影最准确。结论超声造影能更好地评估肝癌介入治疗的疗效。     

实时灰阶超声造影对肝局灶性病变的诊断价值

目的：探讨实时灰阶超声造影对肝局灶性病变的诊断价值。方法：应用新型超卢造影剂SonoVue,对9例原发性肝癌,5例转移性肝癌,5例肝血管瘤,2例肝硬化结节病例进行实时灰阶超卢造影检查,观察各病灶内及肝实质的造影剂动态灌注过程。结果：超声造影后,不同性质的病灶有不同程度、不同特点的增强表现。原发性肝癌表现为动脉相快速增强、而后快速消退;转移性肝癌动脉相表现多样,实质相呈明显的低回声“缺损”区,并且于实质相发现了更多病灶;肝血管瘤动脉相见周边环状增强、而后呈向心性填充;肝硬化结节与周围肝实质呈同步改变。结论：实时灰阶超声造影对肝局灶性病变的定性诊断及病灶的检出明显优于常规超声检查。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.