目的 探讨不同性别浆细胞性乳腺炎(PCM)的临床及超声声像图特征,深入认识男性PCM,提高早期诊断率.方法 回顾性分析经穿刺病理证实且超声资料完整的PCM患者142例,其中男41例;女101例,对比不同性别PCM的临床及超声声像图特征.结果 两组PCM的临床及超声声像图特征比较,在发病年龄、发病区域、病灶大小、超声类型、边界、血流分级、收缩期峰值流速、液化及同侧腋窝淋巴结肿大情况均具有统计学意义(P＜0.05).结论 不同性别PCM在临床及超声声像图特征有所区别,深入对男性PCM的认识,有助于早期诊断及有效治疗.

Objectives This thesis aims to explore the relationship between tea consumption and ankle–brachial index (ABI) and further studies the relationship between tea consumption and lower extremity atherosclerosis. Methods This is a cross-sectional, epidemiological survey of 17,373 subjects selected from the staff of Kailuan Group who had come to Kailuan General Hospital for a health examination from January 2016 to December 2017. Tea consumption was obtained by questionnaires. ABI was measured using an automated analyzer. The other data, such as age, gender, body mass index (BMI), and so on, was collected on the same day of the health examination results. The relationship between tea drinking habits and ABI was studied using logistic regression and multivariate linear regression analysis. Results Among the 17,373 analyzed subjects, the difference in age, gender, BMI, heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), uric acid (UA), C-reactive protein (CRP), fasting blood-glucose (Fbg), and ABI was statistically significant in the tea-drinking group and the nontea-drinking group ( p < 0.05). Multiple logistic regression models revealed that tea consumption was a positive predictor for ABI (odds ratio (OR) = 0.782, confidence interval (CI), 0.615–0.994) ( p < 0.05). Multivariate linear regression analysis of the ABI value showed that frequent tea-drinking has a positive correlation with the ABI value ( p < 0.05). Conclusions The higher tea consumption is significantly associated with higher ABI which means less risk for lower extremity atherosclerosis.

病例 女,30岁,因"无诱因右乳肿胀及占位"于4年前就诊.查体:右侧乳头Ⅲ度内陷,全乳肿胀明显,质软,乳房皮肤无红肿及皮温改变.行乳腺超声检查(图1a):右乳外侧腺体组织紊乱,可见多处混合性回声区,范围分别约45 mm× 10 mm、46 mm×39 mm、54 mm×23 mm,界尚清,形态不规则,CDFI:周边及内可见较丰富血流信号,并可引出高速高阻型动脉血流频谱,PSV:51.7 cm/s,RI:0.78;提示:右乳实性占位性质待定,BI-RADS:4B类.行乳腺磁共振增强成像(图1b):右乳巨大团块稍长T2长T1异常信号影,其内见点条状短T2短T1出血信号影;右乳皮肤弥漫性增厚,悬韧带增厚,增强后显著异常强化,其内见多发类圆形分叶状相对强化结节,时间动态曲线呈流出型,DWI呈稍高信号,ADC值约1.290× 10-3 mm2/s;提示:右乳巨大富血供肿块性病变,BI-RADS:Ⅳ类.遂行右乳肿块切除术,术后病理提示(图1c):肿瘤组成部分呈分化好的血管瘤样结构,部分区域增生活跃,呈实性,细胞呈上皮样紧密排列;免疫组织化学:血管标志物CD31(+)、CD34(+),Ki-67(20％+).病理诊断:符合中-高分化血管肉瘤.遂又行右乳全切除术,1月后随访,患者正接受化疗.

目的 探讨囊性中性粒细胞性肉芽肿性乳腺炎(cystic neutrophilic granulomatous mastitis,CNGM)的超声声像图特征.方法 回顾性分析首都医科大学附属北京中医医院2019年1月至2021年9月经病理确诊的36例CNGM女性患者和超声图像.结果 36例CNGM患者的超声图像可分为4种类型.其中,导管扩张型5例(14％),表现为单支或多支乳腺导管扩张,内部透声欠佳,部分可见细点状弱回声;实性肿块型8例(22％),表现为单发或多发实性病灶,多数形态不规则,内部可见较丰富血流信号;弥漫型9例(25％),乳腺内可见散在、相互延续的病灶,呈片状或团块状,形态多不规则,内部及周边可见较丰富血流信号;脓肿型14例(39％),单发或多发囊实性或以囊性为主的病灶,多数形态不规则,部分可累及体表,周边可见血流信号.结论 CNGM超声检查分为导管扩张型、实性肿块型、弥漫型和脓肿型4种声像图表现,明确不同类型声像图特征有助于CNGM患者的早期诊断.

目的 比较肌肉骨骼超声(MSUS)与MRI在膝类风湿性关节炎(RA)中的诊断价值.方法 在42例单膝RA患者中,于同期行单膝关节MSUS检查及MRI检查,比较MSUS与MRI对滑膜增厚、 关节腔积液、骨质改变、软骨破坏检出率的差异以及软骨破坏与超声滑膜血流分级情况.结果 MSUS对滑膜增厚、 关节腔积液、 骨质改变的检出率(90.48％ 、88.10％ 、71.43％)与同时期MRI(85.71％ 、85.71％、80.95％)比较差异均无统计学意义(P>0.05);对软骨破坏检出率(61.90％)低于M RI(83.33％),差异有统计学意义(P<0.05);以MRI检查为标准,MSUS检查软骨破坏检出符合率为69.05％,其中漏诊11例、误诊2例,漏诊主要集中在Ⅱ ～ Ⅲ级滑膜血流分级中.结论 MSUS对膝RA诊断有一定价值,可用于膝RA的筛查.

目的 探讨超声引导刺络拔罐联合中药治疗肉芽肿性小叶性乳腺炎(granulomatous lobular mastitis,GLM)的临床价值及超声在其中的应用.方法 选取2019年1月—2020年6月期间于首都医科大学附属北京中医医院乳腺科门诊就诊的肉芽肿性乳腺炎患者96例.根据治疗方案分为治疗组和对照组,每组48例,并对所有患者临床及超声资料进行回顾性分析.其中对照组为常规中药治疗,即由乳腺科医生辨证后内服乳痈方,交替外敷自制膏方:芙蓉膏、复方化毒散膏;治疗组在对照组的基础上联合刺络拔罐法,两组患者均治疗1个月后,观察比较两组患者临床疗效,治疗前后症状体征积分、肿块超声参数变化、血流信号分级等.结果 治疗后两组患者乳房疼痛、乳头溢液、局部皮肤改变、乳头凹陷、肿块大小、患侧腋窝淋巴结肿大及症状总积分均较治疗前明显降低,差异有统计学意义(P<0.05);且治疗组治疗后乳房疼痛、乳头溢液、肿块大小及症状总积分均较对照组明显降低,两组比较,差异有统计学意义(P<0.05).治疗后两组患者超声下炎性病灶最大范围和最大液化范围参数均较治疗前明显降低,差异有统计学意义(P<0.05);且治疗组治疗后炎性病灶范围和最大液化范围参数均较对照组明显降低,两组比较,差异有统计学意义(P<0.05).SMI和CDFI检测结果显示两组患者治疗前病灶血流多以Ⅲ级为主,并且SMI检测到Ⅲ级血流病例数高于CDFI,二者差异无统计学意义(P>0.05);治疗后两组肉芽肿性乳腺炎患者病灶血流丰富程度均明显下降;且治疗后血流丰富程度为0和Ⅰ级的病例数高于治疗前的病例数,治疗后血流丰富程度为Ⅱ级和Ⅲ级的病例数低于治疗前的病例数.治疗后治疗组临床疗效总有效率为97.92％(47/48),对照组为93.75％(45/48),两组比较,差异有统计学意义(P<0.05).结论 超声引导刺络拔罐联合中药治疗GLM具有较好的临床疗效,且超声在GLM的诊治过程中能为临床提供准确的影像学诊断及规范的疗效评估,具有重要的临床意义.

目的 探讨超声在贺氏火针法治疗下肢静脉曲张中的应用价值.方法 20例(30条)下肢静脉曲张患者,使用超声在治疗前对患肢进行筛查并评估病情,以贺氏三通法治疗,在治疗后对患肢进行监测,观察患者治疗前后患肢情况、临床疗效、症状评分及不良反应.结果 20例患者30条肢体经过8周贺氏火针治疗后,酸胀乏力等症状均有减轻.患者治疗后洪堡静脉曲张严重程度评分量表(HVVSS)评分较治疗前有明显降低,差异有显著统计学意义(P＜0.05).所有患者均未出现严重并发症,全部患者对治疗效果满意.治疗后合并深静脉瓣膜反流的患肢中,反流程度在Ⅱ级以内的股浅静脉瓣反流时间及反流速度均较治疗前略有减少,隐股静脉瓣反流程度Ⅲ级以上的肢体数为8条(31％),比治疗前有明显减少.结论 超声在下肢静脉曲张行贺氏火针治疗中起到了明确的评估、筛查及及时的监测作用,为贺氏火针进行安全及有效的治疗提供了可靠保证.

OBJECTIVETo evaluate the clinical efficacy on primary varicose veins treated with He's fire needle therapy.METHODSFifty patients of primary varicose veins were randomized into an observation group (25 cases) and a control group (25 cases). In the observation group, He's fire needle therapy was applied for 8 weeks. The fire needling was done on the sites of varicose veins till the bleeding stopped automatically. Additionally, acupuncture with filiform needle was applied to Heyang (BL 55), Chengjin (BL 56), Chengshan (BL 57) and Kunlun (BL 60) on the affected side. In the control group, no intervention was given. The follow-up visit was conducted regularly and since the 8th week, the same treatment as the observation group was provided in the control group. The revised venous clinical severity score (RVCSS) was used for the evaluation of the primary outcomes. The methods for the evaluation of the secondary efficacy outcomes included the venous insufficiency epidemiologic and economic study of quality of life questionnaire scale (VEINES-QOL/sym questionnaire), the venous insufficiency epidemiologic and economic study of symptom score (VEINES-Sym score), the venous insufficiency epidemiologic and economic study of quality of life scale (VEINES-QOL score) and the Homburg varicose vein severity score (HVVSS). The evaluation was conducted at the baseline, at the end of the 4th week and the 8th week separately. The follow-up evaluation was done at the end of the 16th week in the observation group.RESULTSDuring the study, 5 cases were dropped out, accounting for 10%. RVCSS score in the observation group was lower than that in the control group at the end of the 4th and 8th weeks separately (both P < 0.05). VEINES-QOL score and HVVSS score in the observation group were higher than those in the control group at the end of the 4th and 8th weeks separately (P < 0.05, P < 0.01). VEINES-Sym score in the observation group was increased as compared with that of the control group at the end of the 4th and 8th weeks, but the difference was significant at the end of the 8th week (P < 0.01). HVVSS score at the end of the 8th and 16th weeks was reduced as compared with that at the end of the 4th week in the observation group (both P < 0.05).CONCLUSIONHE's fire needle therapy is effective on primary varicose veins. It significantly reduces the severity of disease, the severity of symptoms and the attack frequency of symptoms so that the quality of life is improved in the patients. Additionally, the good long-term efficacy is maintained in 8 weeks after treatment. When the duration of treatment is increased from 4 weeks to 8 weeks, HE's fire needle therapy remarkably improves the efficacy for reducing the symptom severity.

包虫病是一种人畜共患的寄生虫病,根据其流行病学、形态学、形态病理、临床过程及转归等,国内将此分为两种类型:一种由细粒棘球绦虫的囊性包虫病和由多房(泡状)棘球绦虫所致的泡状棘球蚴病(泡型包虫病).根据国内外文献报道及我院统计,以囊型包虫病居多.本组均为囊性病,报道如下.

多发性内分泌腺瘤(MEN)是一种由两个或多个内分泌腺体发生增生或肿瘤而产生的临床综合征,是常染色体显性遗传病,常呈家族性发病.由于受累腺体发病往往不同步,患者就诊时易被当成散发人群对待,贻误家族中其他的隐性患者.我院对1例MENⅡ型的患者进行检查后,又对其弟进行筛查从而发现一例隐匿的MENⅡ型患者.现报道如下.

目的:研究多发性内分泌肿瘤(MEN)的临床特点及其影像学定位诊断.方法:回顾性分析20例多发性内分泌肿瘤临床和影像学检查结果.结果:MEN患者受累腺体的病变为多发性和双侧性.甲状旁腺和甲状腺分别是MEN I型和MENⅡ型最常受累的内分泌腺体,超声和核素联合应用可列为甲状旁腺检查的首选方法.CT结合超声或核素显像可发现全部肾上腺病变.结论:多发性内分泌肿瘤临床表现复杂多样,但是受累腺体病理变化有一定的规律性,而且患者发病呈明显的家族性特点,认识到这些规律,可以早期发现并早期治疗.