目的 了解颈内动脉超声联合经颅多普勒对产后抑郁症患者的检测效果,为临床产后抑制治疗提供有价值的线索.方法 收集本院于2018年3月—2020年2月收治的78例符合抑郁障碍诊断标准的产妇资料,对资料予以回顾研究,并设为研究组,同时另择选78例健康产妇为对照组,应用颈内动脉超声对两组产妇的颈动脉血流参数[颈动脉内径(D)、收缩期峰值流速(PSV)、舒张末期流速(EDV)以及阻力指数(RI)]进行检测,同时联合经颅多普勒超声(TCD)对两组产妇的左右大脑中(MCA)、脑前(ACA)及脑后(PCA)的动脉与椎基底动脉(VA-BA)血流速度进行监测,并分析两组产妇阻力指数(RI)与搏动指数(PI)变化,对以上数据统计分析并给予组间比较分析.结果 与对照组比较,研究组D、EDV水平明显下降,而RI值升高,差异有统计学意义(P<0.05);两组产妇的PSV比较,差异无统计学意义(P>0.05);研究组抑郁产妇的左右大脑中(MCA)、脑前(ACA)及脑后(PCA)的动脉血流速度均加快且差异均有统计学意义(P均<0.05);研究组抑郁产妇的椎基底动脉(VA-BA)血流速度与对照组比较减慢,差异有统计学意义(P<0.05);研究组抑郁产妇的阻力指数(RI)与搏动指数(PI)值与对照组比较,差异均无统计学意义(P>0.05);78例抑郁产妇中,62例呈现脑动脉血流异常.检测异常率为79.49％(62/78).结论 经颅多普勒检测,可见产后抑郁产妇的3条脑动脉血流速度明显加快,而椎基底动脉血流减缓,由此提示抑郁产妇脑动脉痉挛且脑供血明显不足,颈内动脉超声显示抑郁产妇的颈动脉血流参数有一定变化,能够为产后抑郁患者的治疗提供一定参考.

目的 研究男性下尿路症状(LUTS)患者的膀胱出口梗阻(BOO)与前列腺部尿道长度、前列腺体积之间的相关性,探讨前列腺部尿道上下段长度及其比例对BOO的预测价值.方法 选择2014年1月至2017年6月广州新海医院168例男性LUTS门诊或住院患者,未经任何治疗.经直肠超声测量前列腺部尿道长度(PU)、上段长段(SPU)、下段长度(iPU),计算上下段长度之比(SIR);测量并计算前列腺体积(PV),经腹超声测量并计算膀胱残余尿量(RU).尿流动力学检测仪记录膀胱梗阻指数(BOOI),以BOOI≥40判断为BOO.首先根据BOOI≥40与BOOI＜40将资料分为2组,比较2组间上述参数的统计学差异;分析其与前列腺部尿道各段长度及比例、前列腺体积、膀胱残余尿之间的相关性;然后以单因素分析筛选LUTS患者BOOI的影响因素;最后建立受试者操作特性曲线(ROC)评估各参数预测LUTS患者BOO的价值.结果 本组LUTS患者中99例诊断为BOO(58.9％),BOOI与SIR、SPU、RU、PU、PV均有相关性(r=0.427,P=0.001;r=0.387,P=0.027;r=0.313,P=0.019;r=0.308,P=0.032;r=0.269,P=0.038);与IPU、age无相关性(r=0.159,P=0.147;r=0.118,P=0.063).SIR的阳性预测值最高(75.2％,76/101).SIR在BOOI≥40与BOOI＜40两组间相比有统计学意义(t=3.856,P=0.002);SIR≥1.5的患者BOO发生率明显高于SIR＜I.5患者(x2=20.563,P=0.000).ROC分析,以SIR预测LUTS患者BOO的ROC曲线下面积(Area under curve,uC)为0.729±0.061,P=0.002,最佳分界值为1.5,以SIR≥1.5来预测有BOO,敏感性为66.8％,特异性为90.1％.结论 LUTS患者SIR、SPU、PU、RU、PV均与BOO呈正相关;SIR的阳性预测值最高,AUC最大,以SIR≥1.5预测BOO的特异性较高,但敏感性较差.

目的:探讨临床应用中高频彩超引导下对甲状腺结节穿刺诊断的价值方法:在Philips iU Elite高频彩超实时引导下,采用Band自动活检枪配套活检针,对90例甲状腺结节患者进行穿刺活检,每个病灶取材2-4次,活检组织送病理学检查.结果:90例患者在穿刺过程中无不适,成功率为100%,穿刺活检结果与术后病理诊断的结果符合率约97.8%.结论:高频彩超引导下甲状腺结节的穿刺活检术操作简单、经济、安全、穿刺灵活、取材成功率高等优点,对甲状腺结节早期定性诊断有着非常重要的意义,可在临床大力推广.

目的 探讨阴囊积液的高频超声声像图特征,为临床诊断提供依据.方法 回顾性分析143例临床以阴囊积液为首诊的患者的高频彩色多普勒超声声像图特征,并追踪对照其处理结果.结果 143患者中超声诊断为鞘膜积液72例,阴囊血肿20例,腹股沟疝术后腹股沟积液突入阴囊17例,附睾淤积症15例,巨大附睾头囊肿10例,阴囊淋巴管瘤8例,腹股沟斜疝膀胱突入阴囊1例.结论 依据阴囊积液的高频彩色多普勒超声声像图特征进行鉴别诊断,诊断准确、迅速而无痛苦,费用低廉,有很大的临床应用价值.

【Objective】To investigate the effect of trimetazidine on left atrial volume index(LAVI) in patients with chronic heart failure(CHF).【Methods】65 CHF Patients were randomized into trimetazidine group(n=33) and control group(n=32).The control group received conventional therapy,and the trimetazidine group received trimetazidine 20mg tid in addition to conventional therapy,with a follow up of 6 months.Echocardiographic examinations were performed before and 6 months after the study,and LAVIs were measured.【Resluts】Before and 6 months after the study,LAVIs were 43±11.6 mL/m2 vs 34±12.8 mL/ m2 in the trimetazidine group(P<0.05),and 42±10.9 mL/m2 vs 40±8.8mL/m2 in the control group(P>0.05),respectively.【Conclusion】In CHF Patients,addition of trimetazidine to conventional therapy improved LAVI.

【Objective】To explore the impact of psychological intervention on depression in patients with chronic congestive heart failure(CHF) associated with depression and heart function.【Methods】Chronic congestive heart failure with depression were randomLy divided into psychological intervention group(45 cases) and control group(45 cases).The control group was given conventional cardiovascular medications,the intervention group received a comprehensive psychological intervention on the basis of conventional cardiovascular medications,in severe cases of depression taking the amount of antidepressant drugs.All patients were followed up for 3 months.【Resluts】(1)Compared between two groups 3 months after treatment,depression of the treatment group than the control group significantly reduced(P0.01);(2)The NYHA functional grade significantly improved(P 0.05),LVEF significantly increased in treatment group(P 0.05).【Conclusion】With depression in patients with chronic congestive heart failure(CHF),psychological intervention can reduce depression and further improve heart function.

目的:通过B型超声诊断仪检查肝、胆、脾、肾等,分析B超检查在海船船员健康体检中的价值。方法:采用日立5500超声诊断仪,空腹情况下按常规进行肝、胆、脾、双肾、膀胱探测,依据超声医学声像图诊断标准做出诊断,并按45~50岁、51~55岁、56岁以上3个年龄组进行分析。结果:对920例海员船员进行B超肝、胆、脾、双肾、膀胱探测,检出肝、胆、肾疾病等9种,疾病共515例(55.98%)。其中部分病例含有2种或2种以上的异常指标,其中检出肝脏疾病293例(31.8%),占检病率56.9%。脂肪肝172例(18.7%),占检病率33.4%;胆囊疾病119例(12.9%),占检病率23.1%。胆囊息肉样病变共85例(9.2%),占检病率16.5%;胆囊结石共31例(3.4%),占检病率6.0%;泌尿系疾病93例(10.0%),占检病率18.1%。泌尿系统结石46例(5.0%),占检病率7.0%。结论:B超在海船海员行健康体检能及时发现疾病,及时治疗,具有临床应用价值。

Objective To investigate the effect of one-hour postload plasma glucose concentration(1h PG) during oral glucose tolerance test(OGTT) on P wave dispersion(PWD).Methods With a cutoff point of 8.6 mmol/L for the 1h PG,60 subjects with normal glucose tolerance(NGT) were divided into two groups,NGT<8.6 mmol/L(n=45) and NGT≥8.6 mmol/L(n=45).PWD,blood lipid were measured,and echocardiography were performed in the two groups,data of both groups were compared to each other.Results PWD increased in the group of NGT≥8.6 mmol/L,compared to the group of NGT<8.6 mmol/L(42 ±12 vs.34±11,P<0.05).Conclusion PWD increased in NGT subjects with 1 h PG≥8.6 mmol/L and may be the predictor of AF.

Objective To investigate the clinical application of needle biopsy on abdominal mass by color Doppler ultrasonic guidance.Methods In the real time color Doppler ultrasonic guidance, using automatic biopsy gun and 18G cutting biopsy needle, the specimens were extracted in each lesion for 2～3 times.Results In the 41 cases with abdominal masses,the successful rate of extracted specimen was in 100%(41/41).Among them, 30 cases were malignant tumor and 11 cases were benign lesion.The diagnostic coincidence rate was 97.6%.(40/41).Conclusion In the color Doppler ultrasonic guidance, the needle biopsy of abdominal mass has safe, reliable,effective and convenient advantages.

目的探讨高频彩色多普勒超声直视引导技术在滑囊炎治疗中的临床应用价值。方法选择经高频彩色多普勒超声明确诊断为滑囊炎的病人70例,随机均分成2组,A组采用传统盲穿法,B组采用超声引导直视下进行穿刺,均往囊内注射曲安奈德治疗滑囊炎。记录2组穿刺成功及一次成功例数、成功穿刺所需次数、成功穿刺所需时间、并发症等。结果 B组穿刺成功及一次成功率明显高于A组(p<0.05),成功所需次数B组明显少于A组(p<0.05);A组出现5例肌肉血肿、3例刺破肌间动脉、2例滑囊外注射。结论高频彩色多普勒超声直视引导技术在滑囊炎治疗中提高了穿刺成功率及药物疗效,减少并发症,具有很大的临床应用价值。

目的比较分析CT与B超在经皮肺活检上的应用。方法2003年3月至2008年10月广州新海医院83例肺部肿瘤患者在CT与B超引导下经皮肺活检,其中CT组41例,男25例,女16例,B超组42例,男30例,女12例。结果83例患者均能取出合适的标本。并发症B超组有1例痰中带血;CT组有4例痰中带血,7例气胸。结论CT与B超引导下经皮肺活检在肺部外周肿块的临床应用有其优劣性。

Objective To study the influenc of metoprolol succinate sustained-release tablets therapy on ventricular rate and heart function of patients with chronic atrial fibrillation(CHF)and chronic heart failure(HF).Methods A total of 69 patients with chronic atrial fibrillation and chronic heart failure were randomly divided into treatment group(35 cases)and control group(34 cases).The general therapy included digoxin,diuretics,angiotensin-converting enzyme inhibitors(ACEI)or angiotensin-Ⅱ-receptor antagonists(ARB)and anticoagulants for a 6-momth follow-up period.The patients of treatment group was treated with metoprolol succinate sustained-release tablets above the base of the general therapy.The ventricular rate at rest and the ventricular rate after 6-minute walk,left ventricular end diastolic dimension(LVEDD),left ventricular end systolic dimension(LVESD),left ventricular ejection fraction(LVEF)and the distance of 6-minute walk were examined before and 6 months after therapy.After 6 months,to compare the changes of clinical manifestations.Results ①The ventricular rate at rest decreased significantly in both two groups(P＜0.01),the ventricular rate after 6-minute walk decreased significantly in treatment group 6 month after treatment(P＜0.01),but there was no significant difference betwen before and after treatment in control group on the ventricular rate after 6-minute walk(P＞0.05),and the ventricular rate after 6-minute walk was decreased more in tretment group than that in control group(P＜0.01).②The LVEF,LVEDD,LVESD and the distance of 6-minute walk in both groups had significant improvement as compared with before treatment(P＜0.01～0.05),with the treatment group showing a better improvement than in control group(P＜0.05).③The total responsive rate in the treatment group(93.8%)was significantly higher than in control group(77.4%)(P＜0.05).Conclusion Based on the medication of digitalis,diuretics and ACEI or ARB,metoprolol succinate sustained-release tablets therapy can effectively control ventricular rate,significantly improve heart function and also reverse left ventricular in patients with chronic atrial fibrillation and chronic heart failure.

黑色素瘤是一种恶性度极高的肿瘤,较少见,易发生转移。诊断较困难,存活率较低,尚无十分有效的治疗方法。本组仅对黑色素瘤脑转移的临床特点、影像学表现及治疗方法作一综合性论述。

Objective:To investigate the effect of candesartan cilexetil in preventing recurrence of essential hypertension complicated with atrial fibrillation(AF) .Methods:78 patients with essential hypertension complicated with AF who were recovered the sinus rhythm through electrotherapy or medicines were randomly divided into observation group and control group.Aminodarone were used in all patients to keep the sinus rhythm.Candesartan cilexetil 4～8 mg/d was added in observation group,and Norvasc 5～10 mg/d was added in control group.The follow-up lasted one year.The recurrent rates of AF in two groups were observed during one year,the inner diameter of left atrium was measured by echocardiogram and the blood pressure was observed in two groups before and after treatment.Results:The recurrent rate of AF in observation group decreased significantly compared with that in control group(P0.05) .After treatment the inner diameter of left atrium in observation group decreased significantly compared with that before treatment(P0.05) .The inner diameter of left atrium after treatment showed significant difference between the two groups(P0.05) .After treatment there was no significant difference in the blood pressure between the two groups(P0.05) .Conclusions:Long term treatment of candesartan cilexetil may reverse the enlargement of left atrium of patients with essential hypertension complicated with AF,and reduce the onsets of AF.

<正>1临床资料患者女,34岁。因发现左腋窝肿物2年余,于2007年5月30日入院。2年来患者自觉病灶逐渐增大,无不适。入

目的 观察福辛普利、螺内酯与常规抗心力衰竭药物联用治疗充血性心力衰竭的疗效.方法 将86例心力衰竭患者随机分为治疗组43例(福辛普利、螺内酯加常规抗心力衰竭药物)和对照组43例(福辛普利加常规抗心力衰竭药物),疗程8周.观察治疗前后临床心功能、心率、左室射血分数(LVEF)、左室舒张末期内径(LVEDD)和左室收缩末期内径(LVESD)、血生化指标等变化.结果 两组患者临床心功能均有改善、治疗组心力衰竭纠正的有效率显著高于对照组(P＜0.05);治疗组治疗后心率的改善亦优于对照组(P＜0.05);治疗后两组的左室射血分数(LVEF)均有增加,左室舒张末内径(LVEDD)和左室收缩末期内径(LVESD)均有减少;治疗后两组LVEF比较(P＜0.05)、两组LVEDD比较P＜0.01、两组LVESD比较P＜0.01.结论 福辛普利联合螺内酯治疗慢性充血性心力衰竭明显改善心功能、改善左室重塑,治疗有效。

Objective To Study the Cause of Disease Incidence of renal Calculus and the Countermeasure. Method To randomilySample7216 Cases Who were the laudlsmen and Sailors in a same Company and had Somatoscopy in 1999 to Compare the diseaseincidence. Results The Disease incidence of Sailors is significamtly higher than landsmen by Chi - square test (P＜0.01).ConclusionThe major Causes include work environment, food, Sanitary Condition and habit.

为了解海员泌尿系结石患病情况,我们调查了广州海运集团公司1998～1999年间上岸健康体检的5265名运输船舶海员,同时以同期陆上836名工作人员作为对照,并对其患病原因进行探讨.