二维超声与弹性成像对甲状腺良恶性结节诊断的对比研究

目的 探讨二维超声和超声弹性成像鉴别甲状腺结节良恶性的效能和互补性.方法 对98例甲状腺结节患者的129个病灶先后进行二维超声和弹性成像检查,分别计算二维超声具有不同恶性特征数与弹性成像各个分级情况下的敏感性和特异性;绘制两种方法诊断甲状腺恶性结节的ROC曲线,比较其诊断价值.结果 二维超声ROC曲线下面积为0.865,弹性成像ROC曲线下面积为0.938,两种方法经Z检验,Z值=1.268,P=0.2049,提示二者差异无统计学意义.结论 本组病例提示二维超声与弹性成像均能对甲状腺结节的良恶性做出准确判断,两种方法诊断效能相当,在实际工作中应正确认识弹性成像是在二维超声基础上叠加的硬度信息,需要二者结合综合考虑才能提高对甲状腺结节的诊断水平.     

不同流式细胞检测系统测定T细胞亚群的一致性评价

目的根据美国临床实验室标准化委员会(NCCLS)EP9-A2文件对2种流式细胞检测系统进行比对试验,研究不同系统检测结果的一致性。方法收集40例临床样本,分别使用Beckman Coulter公司XL型流式细胞仪和BD公司CANTO型流式细胞仪同时测定样本的T细胞亚群,分析2组结果的相关性和2种系统检测结果的一致性。结果2种检测系统所得的结果相关性良好,不同系统间的预期偏差在允许偏差范围内,可以接受。结论在严格按操作规程进行校准和质控在控的前提下,使用这2种流式细胞检测系统测定外周血T细胞亚群的结果基本一致。     

根据NCCLS-EP9-A2评价2种发光免疫分析法的一致性

目的根据NCCLS-EP9-A2对2种发光免疫分析法进行比对试验,研究2种方法检测结果的一致性。方法收集40例临床血清标本,分别使用Access分析仪和Elecsys2010分析仪同时测定血清标本IgE水平,分析2组结果的相关性和2种方法检测结果的一致性。结果2种方法所得的结果相关性良好(r=0．994),2组结果预期偏差在允许偏差范围内,可以接受。结论在严格按操作规程进行校准和质控在控的前提下,使用这2种发光免疫分析方法测定血清中IgE水平的结果基本一致,在同一实验室可以同时使用这2种方法检测相同项目。     

Disability and health-related quality of life in Guillain-Barré syndrome during the first two years after onset: a prospective study

OBJECTIVE: To describe changes in disability and health-related quality of life in patients with Guillain-Barré syndrome in Sweden during the first two years after onset. SUBJECTS: Forty-four patients were recruited from eight different hospitals, and 42 of them (mean age 52 years) were followed for two years. Evaluations were performed, primarily as home visits, at two weeks, two months, six months, one year and two years after onset. MAIN MEASURES: Disability was measured using the Katz Personal and Extended Activities of Daily Living Indexes, the Barthel Index, the Frenchay Activity Index and assessments of work capacity; health-related quality of life using the Sickness impact Profile. RESULTS: At two weeks, one year and two years after onset of Guillain-Barré syndrome, 76%, 14% and 12% of patients were dependent in personal activities of daily life (ADL); and 98%, 28% and 26% were dependent in instrumental ADL. At two weeks, all of the patients that were working before onset were unable to work owing to Guillain-Barré syndrome; at two years, 17% were unable to work. At two weeks, scores on Sickness Impact Profile were elevated in all dimensions; at two years, they remained elevated in the physical dimension and in the categories home management, work and recreation and pastimes. CONCLUSIONS: The impact of Guillain-Barré syndrome on ADL, work, social activities and health-related quality is considerable two years after onset and presumably persists beyond this time point.     

黏质沙雷菌随机扩增DNA多态性DNA分型

目的明确同一时间段先后分离自同一病房2例患者的两株黏质沙雷菌是否属于同源菌。方法应用随机扩增DNA多态性（RAPD）技术对同一时间段先后自同一病房2例患者痰液标本中分离得的2株黏质沙雷菌进行RAPD基因多态性分析。结果2株黏质沙雷菌扩增出2条不同的电泳带谱。结论2株黏质沙雷菌为不同的RAPD基因型，非同源菌。     

Comparison of Two Different Ultrasound Devices Using Strain Elastography Technology in the Diagnosis of Breast Lesions Related to the Histologic Results

This study was conducted to provide evidence that elastograms of two different devices and different manufacturers using the same technical approach provide the same diagnoses. A total of 110 breast lesions were prospectively analysed by two experts in ultrasound, using the strain elastography function from two different manufacturers (Hitachi HI-RTE, Hitachi Medical Systems, Wiesbaden, Germany; and Siemens eSie Touch, Siemens Medical Systems, Erlangen, Germany). Results were compared with the histopathologic results. Applying the Bowker test of symmetry, no statistically significant difference between the two elastography functions of these two devices was found (p?=?0.120). The Cohen's kappa of k?=?0.591 showed moderate strength of agreement between the two elastograms. The two examiners yielded moderate strength of agreement analysing the elastograms (Hitachi HI-RTE, k?=?0.478; Siemens eSie Touch, k?=?0.441). In conclusion, evidence is provided that elastograms of the same lesion generated by two different ultrasound devices equipped with a strain elastography function do not significantly differ.     

双针双带错位穿刺法在危重患者抢救中的应用

目的 探讨双留置针双止血带错位穿刺法在危重患者抢救中的应用.方法 将驱血带自无充盈静脉肢体近心端加压缠绕至已扎止血带的远心端,人为使其充盈,将2支静脉留置针错开位置穿刺留置.结果 院前急救经双带扎紧后在两条充盈静脉各给予留置针穿刺,一次穿刺成功92.13%,院中急救一次穿刺成功97.83%,平均93.64%;院前急救经双带扎紧后在一条充盈静脉错开位置给予2支留置针穿刺,一次穿刺成功92.86%,院中急救一次穿刺成功100%,平均93.94%.结论 双针双带错位穿刺法能够在短时间内快速建立2条有效静脉通路,提高危重患者抢救成功率.     

双针双带错位穿刺法在危重患者抢救中的应用

目的 探讨双留置针双止血带错位穿刺法在危重患者抢救中的应用.方法 将驱血带自无充盈静脉肢体近心端加压缠绕至已扎止血带的远心端,人为使其充盈,将2支静脉留置针错开位置穿刺留置.结果 院前急救经双带扎紧后在两条充盈静脉各给予留置针穿刺,一次穿刺成功92.13%,院中急救一次穿刺成功97.83%,平均93.64%;院前急救经双带扎紧后在一条充盈静脉错开位置给予2支留置针穿刺,一次穿刺成功92.86%,院中急救一次穿刺成功100%,平均93.94%.结论 双针双带错位穿刺法能够在短时间内快速建立2条有效静脉通路,提高危重患者抢救成功率.

Abstract：

Objective To explore the application of transfer puncture with two indwelling needles in the vein and two tourniquets during first aid treatment of severe patients. Methods Tie expelled blood belt from the proximal of the limb to the distal limb in order to make the vein full with the blood, then put two indwelling needles into the veins. Results The first successful puncture rate was 92.13% to puncture with twoindwelling needles in the vein into two veins after tie two expelled blood belts during the pre-hospital emergency , once success rate was 97. 83% during the mid - hospital emergency , the average rate of them was 93.64% ; The first successful puncture rate was 92. 86% to puncture with two indwelling needles in the vein into a vein after tie two expelled blood belts during the pre-hospital emergency, once success rate 100.00% during the mid - hospital emergency, the average of them is 93.94%. Conclusions Put potent vein passageways quickly of transfer puncture with two indwelling needles in the vein and two tourniquets in the shortesttime in order to make successful boost in first aid for severe patients on during emergency treatment.     

双针双带错位穿刺法在危重患者抢救中的应用

目的 探讨双留置针双止血带错位穿刺法在危重患者抢救中的应用.方法 将驱血带自无充盈静脉肢体近心端加压缠绕至已扎止血带的远心端,人为使其充盈,将2支静脉留置针错开位置穿刺留置.结果 院前急救经双带扎紧后在两条充盈静脉各给予留置针穿刺,一次穿刺成功92.13%,院中急救一次穿刺成功97.83%,平均93.64%;院前急救经双带扎紧后在一条充盈静脉错开位置给予2支留置针穿刺,一次穿刺成功92.86%,院中急救一次穿刺成功100%,平均93.94%.结论 双针双带错位穿刺法能够在短时间内快速建立2条有效静脉通路,提高危重患者抢救成功率.     

眶部肿瘤的CT表现

目的：探讨常见眶部肿瘤的CT表现,材料与方法：经手术病理及临床治疗证实的眶部肿瘤共25例,对它们的CT表现进行回顾性分析。结果：球内肿瘤4例,视网膜母细胞瘤3例,黑色素瘤1例,肌锥内肿瘤6例,海绵状血管瘤和淋巴瘤各2例,淋巴管瘤和炎性假瘤各1例,肌锥外肿瘤8例,炎性假瘤,泪腺混合瘤及皮样囊肿各2例,泪腺囊肿和畸胎瘤各1例;眶上缘皮下肿瘤4例,毛细血管瘤和表皮样囊肿各2例,另3例炎性假瘤有眼外肌和／或泪腺受累,结论：眶部肿瘤的CT表现各有其特点,结合临床及CT检查即可做出一定的定性诊断。     

The complexity of HLA-DS molecules. A homozygous cell line expresses multiple HLA-DS alpha chains

Ia molecules expressed by an HLA-DRw6 homozygous cell line were immunoprecipitated with anti-Ia allosera and monoclonal antibodies and analyzed by 2-D gel electrophoresis. The DRw6 homozygous cell line was shown to express two DS beta chains; this observation extends our previous finding that a DR5 homozygous cell line expresses two DS beta chains and suggests that the expression of at least two DS beta chains by DR homozygous cell lines is a generalized phenomenon. The data presented here document for the first time that a DR homozygous cell line expresses at least two DS alpha chains. Therefore, this cell line expresses at least two DS molecules with the potential for the expression of four DS molecules. In agreement with previous reports, the cell line was shown to express two DR beta chains and one DR alpha chain that combine to form two DR molecules. The molecular specificities of two MB1 allosera and two MB1 -like monoclonal antibodies were also compared in these studies. Both MB1 allosera isolated a single DS molecule, while the MB1 -like monoclonal antibodies isolated at least two DS molecules. Therefore, these studies document for the first time that anti-Ia reagents which are specific for the MB1 or MB1 -like determinants in population studies do not recognize the same Ia molecules in immunochemical studies. The data presented here for the expression of at least two DS alpha chains and the location of the MB1 allodeterminant on only one of multiple DS molecules are in agreement with recent studies at the gene level.     

Reliability of sonographic measurement of the fetal foot

Reliability of sonographic measurement of the fetal foot was tested. Nineteen fetuses of 16 to 40 weeks gestational age were scanned by two physicians in two different planes of measurements. Repeatability of two measurements of each fetus by the same observer and agreement between the two planes was analyzed using the appropriate statistical method. Good agreement in repeated measurements for and between the two planes was found.     

新生儿脐静脉置管两种封管液应用效果比较

目的 探讨新生儿脐静脉置管两种封管液应用效果.方法 将72例留置脐静脉导管的新生儿配对分为两组,分别应用0.9％生理盐水(34例)、10 U/mL肝素盐水(38例)在患儿输液结束后进行封管.比较两组患儿导管留置时间、导管留置相关并发症发生率.结果 两组患儿导管留置天数、脐静脉导管并发症发生率比较,差异无统计学意义(均P＞ 0.05).结论 0.9％生理盐水作为脐静脉置管封管液,能有效维持管道通畅,且更加符合新生儿生理健康需求,值得临床推广应用.     

房间隔瘤的超声心动图诊断

９例房间隔瘤均经超声心动图诊断,其中３例经手术证实。房间隔瘤突向右房５例,突向左房２例,随心动周期在两心房间摆动２例,房间隔瘤的膨出方向决定两两心房间的压力阶差。     

弱CO2激光与红外线照射促进骨折愈合作用的比较研究

目的 以探讨弱CO2激光和红外线照射对骨折愈合的影响。方法 将实验性骨折家兔分为3组,A组：接受150mW/cm^2的CO2激光照射;B组：接受普通红外线照射;C组（对照组）：接受0mW/cm^2的CO2激光照射。采用病理组织学观察骨折区骨痂和血管形成情况;X线片观察骨愈合级别;化学回滴定法测量骨痂中钙含量。结果（1）A组较B组及C组骨折血肿吸收加快,毛细血管更为丰富,骨小梁形成明显加速,以膜性成骨为主;（2）主线显示同时间骨折愈合,A组较B组,C组良好,达Ⅲ、Ⅳ级愈合者非常显著的增高（P＜0．01）;（3）同时间骨痂中胶骨和钙的含量,A组较B组、C组有明显增高（P＜0．01）。结论 弱CO2激光照射能更好的改善局部血液循环和微环境,调节细胞功能,增强成骨能力,加速骨胶原的形成和钙盐的沉积,从而加速骨折的修复过程,促进骨折愈合。     

不同喂养方式对早产儿近期生长发育的影响

目的探讨不同喂养方式对早产儿近期生长发育的影响。方法将90例早产儿按喂养方式分为奶粉喂养、母乳喂养和混合喂养3组,监测各组出生时、纠正胎龄40周、纠正年龄1月、纠正年龄2月时身长、体质量、头围等指标的变化。结果纠正胎龄40周时,母乳喂养组体质量、身长、头围、体质量增加量、头围增加量、年龄别体质量z评分等指标均大于其余两组,差异有显著性（F=5.110~27.738,P〈0.05）。奶粉喂养组身长增加量小于其余两组,差异有显著性（F=25.311,P〈0.05）。纠正年龄1月时,奶粉喂养组身长增加量大于其余两组,差异有显著性（F=6.518,P〈0.05）;母乳喂养组体质量增加量、头围增加量大于其余两组,差异有显著性（F=8.770、19.482,P〈0.05）。纠正年龄2月时,奶粉喂养组体质量、身长、体质量增加量、头围增加量大于其余两组,差异有显著性（F=4.047~17.044,P〈0.05）;母乳喂养组身长增加量小于其余两组,差异有显著性（F=22.241,P〈0.05）。结论纠正胎龄40周时母乳喂养组生长占优势,此后奶粉喂养组生长占优势。     

An experimental basis for revising the graphic rating scale for pain

Seven subjects judged the differences between electrocutaneous shocks and words from two category rating lists describing those sensations in each of two difference estimation experiments. The electrocutaneous shocks used for the two experiments were 10 suprathreshold shock intensities determined separately for each subject. There were two distinct 7-word category rating lists. Both lists shared 6 common words; however, the seventh word made the rational ordering of the two lists different.Magnitude scales of meaning for the category rating words and sensory scales for the electrocutaneous shock intensities were determined for each of the two experiments for each subject using conjoint measurement analysis. Comparisons of the sensory scales for electrocutaneous shock between the two difference estimation experiments for each subject showed that they judged the electrocutaneous shocks similarly with the two word lists. This allowed for comparisons between the scales of meaning for the words from the category rating lists. The two word lists were not equivalent. There was substantial agreement among the subjects on characteristic spacings of quantitative values for the category rating items. These results suggest that clinical rating scales used for analgesimetry should not assume homogeneity of spacing of category items. A scale incorporating our subjects' common understanding is presented.     

Prenatal diagnosis of cephalothoracopagus janiceps disymmetros using three-dimensional power Doppler ultrasound and magnetic resonance imaging.

We report the prenatal imaging findings of a rare case of cephalothoracopagus janiceps disymmetros diagnosed at 28 weeks' gestation. Two-dimensional ultrasound and magnetic resonance imaging demonstrated janiceps conjoined female twins with a single fused cranial vault, duplicated cerebra, two faces, four eyeballs, a fused thorax, two hearts, two thoracic spines, eight limbs and polyhydramnios. Three-dimensional and power Doppler ultrasound established the definitive classification of cephalothoracopagus conjoined twins and displayed the shared circulation between the two separate hearts.     

热缺血期通气对大鼠无心跳供肺的作用

目的:探讨大鼠肺移植手术中,心脏停跳后热缺血期通气对大鼠无心跳供肺的影响。方法:雄性Sprague-Dawley(SD)大鼠64只,按供体鼠体质量稍轻于受体鼠的原则,将其随机配成32对。将32对大鼠随机分为热缺血3h不通气组(warm is-chemia with non-ventilation,WNV组)和热缺血3h并机械通气3h组(warm ischemia with ventilation,WV组)2组,每组16对;每组大鼠根据再灌注时间,分为再灌注2h亚组和再灌注24h亚组,每亚组8对。建立大鼠无心跳供肺移植模型,再灌注2h或24h后对移植肺进行血气分析并处死大鼠,取其肺组织,检测肺湿干质量比、肺损伤病理评分、细胞凋亡等指标并在电镜下观察细胞超微结构。结果:左肺静脉的氧分压(PaO2)在WNV组和WV组的2个再灌注2h亚组之间以及2个再灌注24h亚组之间均有显著差异(P<0.05),右颈动脉PaO2仅在2个再灌注24h亚组之间有显著差异(P<0.05);左肺湿干质量比和光镜形态学病理损伤评分在2个再灌注24h亚组之间均有显著差异(P<0.05);细胞凋亡指数在2个再灌注2h亚组之间有显著差异(P<0.05);电镜观察显示WV组细胞超微结构的损伤较WNV组轻。结论:热缺血期通气能够改善大鼠无心跳供肺移植缺血再灌注肺损伤,提示无心跳供肺热缺血时间在低温且肝素化通气状况下可达3h。     

2型糖尿病并发脂肪肝患者的饮食、运动行为与代谢特征及其临床意义

目的评价2型糖尿病并发脂肪肝患者饮食、运动行为与代谢特征.方法糖尿病患者60例,其中糖尿病并发脂肪肝组30例、糖尿病非脂肪肝组30例,比较两组患者饮食、运动行为与代谢特征.结果糖尿病并发脂肪肝患者临床上往往缺乏典型的临床症状;近80%的糖尿病并发脂肪肝患者超重、肥胖、饮食习惯不良、饮食结构不合理;80%的糖尿病并发脂肪肝患者平时喜静少动、几乎不参加运动;3/4的糖尿病并发脂肪肝患者各项代谢指标异常.结论糖尿病并发脂肪肝组患者饮食、运动行为不良,体重指数、血脂等部分代谢指标比糖尿病非脂肪肝组异常率明显增高.