Deep vein thrombosis (DVT) is a common complication after orthopedic surgery. This prospective observational study evaluated whether a single preoperative baseline measurement of the venous circumference-squared-to-area ratio (C2/A), alone and with D-dimer, was associated with DVT detected during the first 7 postoperative days. One hundred fifty adults undergoing orthopedic surgery were enrolled; 37 developed DVT and 113 did not. Preoperative circumference (C) and area (A) were measured separately at end-expiration with the ultrasound system's built-in measurement package during the same acquisition cycle. Investigators calculated C2/A as C2 divided by A. To apply this rule consistently to the retained participant-level dataset, all revision analyses used C2/A recalculated from the retained C and A fields. Postoperative ultrasound was performed at 12-h intervals for 7 days under a prespecified intensified study-surveillance schedule used only for outcome ascertainment. The areas under the receiver operating characteristic curves were 0.893 for common femoral vein C2/A, 0.817 for superficial femoral vein C2/A, 0.906 for popliteal vein C2/A, and 0.834 for D-dimer. The originally specified superficial femoral vein C2/A plus D-dimer model had an apparent area under the curve of 0.887 and a stratified 5-fold cross-validated out-of-fold area under the curve of 0.877. A 5-variable exploratory model had an out-of-fold area under the curve of 0.938. Using cohort-derived thresholds of 16.26 for superficial femoral vein C2/A and 2.15 mg/L FEU for D-dimer, DVT occurred in 0 of 78 patients with neither marker elevated, 15 of 50 with one elevated, and 22 of 22 with both elevated. Preoperative venous C2/A and D-dimer were associated with early postoperative DVT, but the thresholds and models are exploratory and require external validation.

C-C motif chemokine ligand 2(CCL2)is a member of the chemo-kine family and is also known as monocyte chemoattractant pro-tein-1.It is a crucial factor for regulating the migration and infiltration of various immune cells,such as monocytes,macro-phages,and memory T cells.C-C motif chemokine receptor 2(CCR2),a protein-binding receptor with a 7-transmembrane struc-ture,is the primary receptor of CCL2.Upon binding to CCL2,CCR2 undergoes a conformational change,triggering the dissociation of the G protein into its Gα and Gβγ subunits.

AIMS:This study combined a new ultrasound venous filling degree (VFD) parameter with the Caprini score to assess the clinical value of the Caprini score in predicting deep venous thrombosis (DVT) of the lower extremities. METHODS:This retrospective study included 150 inpatients undergoing orthopedic lower extremity surgery at the First Affiliated Hospital of the Air Force Medical University between June 2023 and June 2024. They included 41 (27.3%) cases of knee arthroplasty, 32 (21.3%) hip arthroplasty, 30 (20%) knee arthroscopy, 28 (18.7%) lower limb fractures, 12 (8%) bone tumor, and 7 (4.7%) cases of other surgery types. The data collected involved preoperative vein diameter, flow velocity, blood flow, venous lumen cross-sectional perimeter (C), lumen cross-sectional area (A), C2/A ratio (VFD) of the common femoral vein (CFV), femoral vein (FV), and popliteal vein (POV). The postoperative sonographic parameters and clinical data were compared between the DVT and non-DVT groups. Receiver operating characteristic (ROC) curve of parameters was evaluated as predictive values for DVT. Additionally, the C2/A ratio was combined with the Caprini score to assess their combined impact on DVT prediction. RESULTS:There were significant differences in ultrasound parameters of CFV inner diameter, CFV blood flow, CFV-C, CFV-A, CFV-C2/A, FV blood flow, FV-C, FV-C2/A, POV blood flow, POV-C, POV-A, and POV-C2/A between the DVT group (24.7%, 37/150) and the non-DVT group (75.3%, 113/150) (all p < 0 .05). Area under curve (AUC) for the C2/A (CFV, FV, and POV) were 0.939 (95% confidence interval (CI): 0.888-0.972, p < 0.001), 0.937 (95% CI: 0.886-0.970, p < 0.001), and 0.917 (95% CI: 0.861-0.956, p < 0.001), respectively. When the Caprini score >2, an AUC for predicting DVT was 0.844 (95% CI: 0.776-0.899, p < 0.001). The AUC of the Caprini score >2 combined with C2/A (CFV, FV, and POV) were 0.953 (95% CI: 0.905-0.981, p < 0.001), 0.965 (95% CI: 0.922-0.988, p < 0.001), and 0.948 (95% CI: 0.900-0.978, p < 0.001), respectively. CONCLUSIONS:The ultrasound parameter of VFD-C2/A shows a high predictive value for DVT in patients undergoing orthopedic surgery. Combined with the Caprini score, the predictive value of DVT may be further enhanced compared to using the Caprini score alone.

Adriamycin (ADR), as an anti-cancer drug in routine clinical application, is utilized to treat various cancers such as ovarian cancer, hematological malignant tumor, and endometrial carcinoma. However, its serious dose-dependent cardiotoxicity extremely limits its clinical application. Currently, there remains a dearth of therapeutic agents to mitigate ADR-induced cardiotoxicity. Extensive research has demonstrated that ADR can simultaneously trigger various regulated cell death (RCD) pathways, such as apoptosis, autophagy, ferroptosis, necroptosis, and pyroptosis. Therefore, drugs targeting these RCD pathways may represent effective strategies for treating ADR-induced cardiotoxicity. Natural products, with their wide availability, low cost, and diverse pharmacological activities, have increasingly gained attention. Various natural products, including polyphenols, flavonoids, terpenoids, and alkaloids, can target the RCD pathways involved in ADR-induced cardiotoxicity. Furthermore, these natural products have exhibited excellent properties in preclinical studies or in vitro experiments. This review summarizes the mechanisms of RCD in ADR-induced cardiotoxicity and systematically reviews the natural products targeting these RCD pathways. Finally, we propose future research directions of natural products in this field.

Cardiac fibrosis plays a critical role in the progression of various forms of heart disease, significantly increasing the risk of sudden cardiac death. However, currently, there are no therapeutic strategies available to prevent the onset of cardiac fibrosis. Here, biomimetic ATP-responsive nanozymes based on genetically engineered cell membranes are adapted to specifically recognize activated cardiac fibroblasts (CFs) for the treatment of cardiac fibrosis. By fusing the anti-FAP CAR genetically engineered cell membrane to zeolitic imidazole frameworks-90 (zif-90) cores loaded with antioxidant nanozymes CeO2 and siCTGF (siRNA targeting CTGF), these nanoparticles, called FM@zif-90/Ce/siR NPs, are demonstrated to effectively reduce the accumulation of myofibroblasts and the formation of fibrotic tissue, while restoring cardiac function. These findings demonstrate that the combination of CeO2 and siCTGF has a beneficial curative effect on cardiac fibrosis, with significant translational potential.

肥厚型心肌病是常见的遗传性心肌病，具有高度异质性和高猝死率的特点，是儿童心原性猝死的最常见原因。该文对儿童肥厚型心肌病的药物及侵入性治疗、心律失常管理、特殊类型肥厚型心肌病治疗等方面的研究进展进行综述，以期为临床治疗及进一步研究提供参考。.

肥厚型心肌病是最常见的遗传性心血管疾病，也是年轻人和运动员发生心原性猝死（SCD）的首要原因。早期识别SCD高危患者、及时采取干预措施对预防患者发生SCD相关事件至关重要。国际临床指南推荐的多种SCD风险预测模型可快速评估患者SCD风险并提供合理指导，大大改善高危患者的预后。该文就目前肥厚型心肌病患者SCD风险评估模型的现状及最新进展进行综述，以期为肥厚型心肌病患者的风险识别、精准诊疗提供依据。

1 病例简介 男,41岁,主诉:胸闷气短、呼吸困难1年,加重1个月.10年前有车祸外伤史,2019年12月出现间歇性胸闷气短,当地医院诊断为先天性心脏病、三尖瓣前瓣裂并关闭不全.

Objective:To investigate the relationship between carotid atherosclerosis(CAS)and subclinical left ventricular(LV)dysfunction in type 2 diabetes mellitus patients with preserved LV ejection fraction(LVEF).Methods:A total of 120 patients with type 2 diabetes mellitus who had LVEF≥50% were selected in the Department of Endocrinology, the First Affiliated Hospital of Air Force Medical University from June 2021 to October 2021. The global longitudinal strain(GLS)was obtained by two-dimensional speckle tracking echocardiography(STE)to assess subclinical LV systolic function. The mitral ratio of peak early to late diastolic filling velocity(E/A), and mitral velocity to early diastolic velocity of the mitral annulus(E/E′)ratio were obtained by pulsed tissue Doppler echocardiography to assess LV diastolic function. Acrroding to bilateral carotid ultrasound examination, the subjects were divided into normal carotid arteries group( n=46) and CAS group( n=74). Demographics and biochemical parameters were compared between two groups. Binary logistic regression and Pearson correlation analysis were used to evaluate the relationship between CAS and subclinical LV dysfunction. Results:The CAS group had a higher proportion of men, older age, and a longer duration of diabetes than the normal carotid arteries group(all P<0.05). There was no difference in LVEF and GLS between the two groups [normal carotid arteries group vs CAS group, LVEF: (60.72±4.73)% vs(60.07±4.28)%; GLS: (18.24±3.72)% vs(17.81±3.47)%, respectively; both P>0.05]. However, compared with normal carotid arteries group, E/A ratio was decreased and E/E′ ratio was significantly increased in CAS group(both P<0.01). Pearson correlation analysis showed that GLS was not correlated with carotid plaque thickness and carotid intima-media thickness(CIMT; both P>0.05). By contrast, E/E′ ratio was positively correlated with carotid plaque thickness and CIMT(both P<0.05). Binary logistic regression analysis showed that GLS and E/E′ ratio were not associated with CAS( both P>0.05). However, decreased E/A ratio was significantly associated with the existence of CAS( OR=0.09, 95% CI 0.01-0.67, P=0.018). Conclusions:In type 2 diabetes mellitus patients without overt heart failure and with preserved LVEF, the occurrence of CAS is not associated with subclinical LV systolic impairment assessed by GLS, but is significantly associated with LV diastolic dysfunction, and is independent of traditional cardiovascular risk factors.

Hypertrophic cardiomyopathy (HCM) represents one of the most common inherited cardiac conditions, and more than 50 % have a tendency of familial aggregation. However, there is a lack of plenty pedigrees to analyze the clinical characteristics. This study collected 1023 unrelated HCM probands, conducted Sanger sequencing on whom carrying MYH7-R143Q and analyzed the clinical data. The detection rate of MYH7-R143Q was 2.54 % (26/1023). In patients with HCM carrying MYH7-R143Q, the diagnosis age is often concentrated in 31-40 years with moderate hypertrophy and fibrosis, which usually concentrate in the anterior and inferior septum of the basal and mid regions, representing moderate risk of SCD. Besides, this variant represented different genetic characteristics, including incomplete penetrance of autosomal dominant inheritance, polygenic cumulative effect and et al. It is the first time to investigate clinical phenotypes in multiple families carrying the same variant locus MYH7-R143Q, providing a theoretical basis for genetic counseling in clinical practice.

目的 比较慢性静脉疾病评分与反流时间评估疾病严重程度的价值.方法 回顾性分析2017年11月至2020年7月空军军医大学西京医院超声科诊断的507例原发性反流型慢性静脉疾病(chronic venous disease,CVD)患者,根据CEAP分级进行分组比较,以受试者工作特征曲线分析探究静脉临床严重程度评分(venous clinical severity score,VCSS)及沉重感/疼痛/肿胀/痉挛/瘙痒(heaviness/ache/swelling/throbbing/itching,HASTI)评分用于评估疾病严重程度的截点值.结果 在各类型的反流病例中,VCSS随着疾病严重程度的增大而增大(P＜0.05),区分C1～2与C3～4、C3～4与C5～6的截点值分别为3.5～4.5分和8.5～14.5分.HASTI评分在C3～4级显著高于C1～2级(P＜0.05),截点值为7.5～9.5分.在单纯浅静脉反流(As)和浅及深静脉合并穿支反流(Asdp)病例中,各临床分级间的反流时间参数差异无统计学意义(P＞0.05);在浅静脉合并深静脉反流病例(Asd)中,C5～6级的深静脉反流时间较C3～4级延长(股总静脉:P=0.008;腘静脉:P=0.044);在浅静脉合并胫部穿支静脉反流病例(Asp)中,小隐静脉近心段(P=0.037)和穿支静脉(P=0.0002)的反流时间在C3～4级较C1～2级缩短,同时伴穿支静脉内径增宽(P=0.034).结论 VCSS与HASTI评分用于评估CVD严重程度的参考区间分别为C1～6分级与C1～4 分级,反流时间参数仅能区分浅静脉合并深静脉反流终末期病例(C3～6Asa)或浅静脉合并穿支静脉反流早期病例(C1～4Asp)的疾病严重程度.

目的 应用超声测量静脉管腔横截周长(C)、面积(A),计算C2/A,探讨该参数对骨科住院患者下肢深静脉血栓的预测价值.方法 选取于我院骨科拟行手术的无血栓住院患者150例,其中术后7 d内发生血栓37例(血栓组),未发生血栓113例(无血栓组);比较两组术前超声参数包括股总静脉(CFV)、股静脉(FV)、腘静脉(POV)C、A、C2/A、流速及内径的差异;绘制受试者工作特征(ROC)曲线分析CFV、FV、POV各超声参数预测下肢深静脉血栓的诊断效能.结果 与无血栓组比较,血栓组CFV内径、CFV-C、CFV-C2/A、FV-C、FV-C2/A、POV-C、POV-A和POV-C2/A均增加,差异均有统计学意义(均P<0.05).ROC曲线分析显示,当CFV-C2/A、FV-C2/A、POV-C2/A截断值分别为>17.2、17.1、17.1,预测下肢深静脉血栓的曲线下面积分别为0.953[95％可信区间(CI):0.922～0.974,P<0.001]、0.933(95％CI:0.899～0.959,P<0.001)、0.919(95％CI:0.882～0.947,P<0.001),灵敏度分别为93.2％、95.5％、88.6％,特异度分别为94.1％、89.8％、91.0％.结论 超声参数C2/A对骨科住院患者下肢深静脉血栓有一定的预测价值.

Objective: To observe the association between clinical phenotypes of hypertrophic cardiomyopathy (HCM) patients and a rare calcium channel and regulatory gene variation (Ca2+ gene variation) and to compare clinical phenotypes of HCM patients with Ca2+ gene variation, a single sarcomere gene variation and without gene variation and to explore the influence of rare Ca2+ gene variation on the clinical phenotypes of HCM. Methods: Eight hundred forty-two non-related adult HCM patients diagnosed for the first time in Xijing Hospital from 2013 to 2019 were enrolled in this study. All patients underwent exon analyses of 96 hereditary cardiac disease-related genes. Patients with diabetes mellitus, coronary artery disease, post alcohol septal ablation or septal myectomy, and patients who carried sarcomere gene variation of uncertain significance or carried>1 sarcomere gene variation or carried>1 Ca2+ gene variation, with HCM pseudophenotype or carrier of ion channel gene variations other than Ca2+ based on the genetic test results were excluded. Patients were divided into gene negative group (no sarcomere or Ca2+ gene variants), sarcomere gene variation group (only 1 sarcomere gene variant) and Ca2+ gene variant group (only 1 Ca2+ gene variant). Baseline data, echocardiography and electrocardiogram data were collected for analysis. Results: A total of 346 patients were enrolled, including 170 patients without gene variation (gene negative group), 154 patients with a single sarcomere gene variation (sarcomere gene variation group) and 22 patients with a single rare Ca2+ gene variation (Ca2+ gene variation group). Compared with gene negative group, patients in Ca2+ gene variation group had higher blood pressure and higher percentage of family history of HCM and sudden cardiac death (P<0.05); echocardiographic results showed that patients in Ca2+ gene variation group had thicker ventricular septum ((23.5±5.8) mm vs. (22.3±5.7) mm, P<0.05); electrocardiographic results showed that patients in Ca2+ gene variation group had prolonged QT interval ((416.6±23.1) ms vs. (400.6±47.2) ms, P<0.05) and higher RV5+SV1 ((4.51±2.26) mv vs. (3.50±1.65) mv, P<0.05). Compared with sarcomere gene variation group, patients in Ca2+ gene variation group had later onset age and higher blood pressure (P<0.05); echocardiographic results showed that there was no significant difference in ventricular septal thickness between two groups; patients in Ca2+ gene variation group had lower percentage of left ventricular outflow tract pressure gradient>30 mmHg (1 mmHg=0.133 kPa, 22.8% vs. 48.1%, P<0.05) and the lower early diastolic peak velocity of the mitral valve inflow/early diastolic peak velocity of the mitral valve annulus (E/e') ratio ((13.0±2.5) vs. (15.9±4.2), P<0.05); patients in Ca2+ gene variation group had prolonged QT interval ((416.6±23.1) ms vs. (399.0±43.0) ms, P<0.05) and lower percentage of ST segment depression (9.1% vs. 40.3%, P<0.05). Conclusion: Compared with gene negative group, the clinical phenotype of HCM is more severe in patients with rare Ca2+ gene variation; compared with patients with sarcomere gene variation, the clinical phenotype of HCM is milder in patients with rare Ca2+ gene variation.

BackgroundThis study aimed to explore the diagnostic value of contrast-enhanced echocardiography (CEE) in benign and malignant cardiac tumors and detect the correlation of CEE parameters and immunohistochemistry (IHC) markers. MethodsThe data of 44 patients with cardiac tumors confirmed by pathology were reviewed. Lesions were examined before surgery using transthoracic echocardiography (TTE) and CEE with time-intensity curve analysis. The expression of CD31, VEGF and Ki67 was measured by IHC staining. Microvessel density (MVD) was quantified via IHC for CD31. The clinical variables, TTE, CEE and IHC parameters were compared between benign and malignant cardiac tumors. Receiver operating characteristic curve were used to analyze the value of factors in predicting malignant cardiac tumors. The correlation between CEE and IHC parameters was analyzed. ResultsAmong 44 cardiac tumors, 34 were benign and 10 were malignant. There were significant differences in the TTE parameters (pericardial effusion, tumor boundary, diameter, basal width), CEE parameters (tumor peak intensity (TPI), peak intensity ratio of tumor to myocardium (TPI/MPI), area under time-intensity curve (AUTIC)) and IHC parameters (Ki67, MVD, CD31, VEGF) between the benign and malignant tumor groups (all P < 0.05). Receiver operating characteristic curve analysis showed that the CEE and IHC parameters had diagnostic value in malignant cardiac tumors. There was a correlation between TPI/MPI and Ki67 (r = 0.62), AUTIC and Ki67 (r = 0.50), and AUTIC and CD31 (r = 0.56). ConclusionTTE and CEE parameters were different between benign and malignant cardiac tumors. CEE is helpful to differentiate the properties of cardiac tumors. There is a correlation between CEE parameters and IHC markers. AUTIC and TPI/MPI can reflect the proliferation and invasion of tumors.

Objective:To evaluate the clinical efficacy of percutaneous intramyocardial septal radiofrequency ablation (PIMSRA) in the treatment of obstructive hypertrophic cardiomyopathy (HOCM) with mild septal hypertrophy.Methods:Forty-five HOCM patients with mild septal hypertrophy (the maximal left ventricular wall thickness is 15-19 mm) who were treated with PIMSRA between November 2016 to February 2021 in the Hypertrophic Cardiomyopathy Center of Xijing Hospital of Air Force Military Medical University were enrolled, and their clinical datas were collected and analyzed. The clinical symptoms and NYHA functional class before operation, 6 months and 1 year after operation were collected. Interventricular septum thickness, left ventricular outflow tract pressure gradient, left ventricular outflow tract diameter, mitral regurgitation, left ventricular systolic and diastolic function were evaluated by transthoracic echocardiography before operation, 6 months and 1 year after operation, intraoperative complications were monitored and recorded. Postoperative arrhythmias were monitored by routine 12 lead ECG and 24-hour ambulatory ECG.Results:All patients successfully completed PIMSRA procedure.No clinical adverse events such as death, bleeding and stroke occurred during and around the operation.No left bundle branch block, complete atrioventricular block and malignant arrhythmia occurred after the operation. All patients did not need permanent pacemaker implantation.NYHA functional class and clinical symptoms of patients were significantly improved after 6 months compared with values before operation (all P<0.001, respectively), it remained stable for 1 year after operation; Anterior interventricular septum, posterior interventricular septum, maximal left ventricular wall thickness all significantly decreased (all P<0.001, respectively), left ventricular outflow tract diameter widened ( P<0.001), continuous improvement 1 year after operation; left ventricular outflow tract gradient and provoked left ventricular outflow tract gradient all significantly decreased, mitral regurgitation decreased and SAM classification reduced after 6 months compared with values before operation (all P<0.001, respectively); left ventricular end-diastolic diameter widened and left atrial diameter decreased (all P<0.001, respectively), it remained stable for 1 year after operation. Left atrial volume index decreased ( P<0.001), with continuous improvement 1 year after operation; The ratio of early diastolic mitral valve velocity to early diastolic mitral annulus velocity (E/e′) decreased ( P=0.001), it remained stable for 1 year after operation. There were no significant differences in left ventricular end diastolic volume, left ventricular end systolic volume and left ventricular ejection fraction among the three groups (all P>0.05). Conclusions:PIMSRA is effective in the treatment of obstructive hypertrophic cardiomyopathy with mild ventricular septal hypertrophy.

目的 总结儿童肥厚型心肌病(HCM)中Noonan综合征的基因变异与临床特征.方法 对123例儿童肥厚型心肌病先证者进行96个遗传性心肌病相关基因的二代测序及生物信息学分析,确定变异位点;筛选出11例Noonan综合征患儿,收集其临床资料及超声心动图结果.结果 11例患儿均因心肌肥厚就诊,男5例、女6例,肥厚型心肌病诊断中位年龄2岁7个月(5个月～10岁),Noonan综合征诊断中位年龄6岁9个月(7个月～16岁).11例患儿中10例为3号染色体RAF 1基因型,1例为12号染色体PTPN 11基因型;7例为新发变异,其中1例RAF 1基因患儿检测出同时携带与肥厚型心肌病相关的变异基因MYBPC 3.11例患儿中9例具有典型Noonan综合征面部特征.11例患儿均为肥厚型心肌病,9例为梗阻性肥厚型心肌病,合并右室流出道梗阻2例,合并先天性心脏病7例.结论 以肥厚型心肌病为表型的儿童Noonan综合征多为RFA 1基因型,易发生左心室流出道梗阻且多合并先天性心脏病.

The patient’s preoperative results of transthoracic echocardiography（TTE） indicated that vegetations were formed in the aortic valve, ductus arteriosus and descending aorta. Active arch replacement was planned for treating with the descending aorta. According to preoperative results from three-dimensional transesophageal echocardiography（3D-TEE）, calcification was found in the vegetations of the descending aorta which was relatively stable. The calcification was distributed in a "ring" shape without adjacent blood vessels invaded. Therefore, no further treatment was performed on the descending aorta while aortic valve vegetation dissection, aortic valve replacement, ligation of patent ductus arteriosus and dissection of vegetations were performed. The followed-up was conducted for three months after the operation which no symptoms such as fever, limb and important organ embolism.

患儿男，5岁，因"自幼肺部听诊有杂音，偶有胸痛，当地医院诊断为室间隔缺损"就医。查体：双肺呼吸音清，未闻及干湿性啰音，心率85次/min，律齐；血压95/64 mmHg(1 mmHg＝0.133 kPa)，心前区无隆起，心尖搏动位于左锁骨中线内侧0.5 cm处，心尖部可闻及2~3级杂音，无其他阳性体征。既往无其他病史。

目的 观察健康成人颈内静脉(IJV)特征及其周长与个体基线资料的相关性.方法 前瞻性纳入571名健康成年体检者,采用二维超声测量其双侧IJV周长,计算周长之和及周长之差;评估IJV类型,行Pearson相关性分析及多变量线性回归分析,观察IJV周长与个体基线资料的相关性.结果 受试者身高、体质量及体表面积(BSA)存在明显性别差异(P均＜0.05),双侧IJV周长及之和则均无明显性别差异(P均＞0.05).IJV在39.23％(224/571)个体呈右侧优势型,43.26％(247/571)呈均衡型,17.51％(100/571)呈左侧优势型.右侧IJV周长与年龄呈低度正相关(r=0.407,P＜0.001),与体质量指数(BMI)呈弱正相关(r=0.179,P＜0.001);左侧IJV周长与年龄呈低度正相关(r=0.302,P＜0.001),与体质量、BMI及BSA呈弱正相关(r=0.215、0.231、0.194,P均＜0.001);双侧IJV周长之和与年龄呈低度正相关(r=0.453,P＜0.001),与体质量、BMI及BSA呈弱正相关(r=0.214、0.261、0.179,P均＜0.001).双侧IJV周长之和与年龄及BMI均相关(P均＜0.001).结论 健康成人颈内静脉多呈右侧优势型或均衡型,双侧颈内静脉周长之和与年龄及BMI相关.