目的 探讨应用超声造影技术评估肝细胞肝癌血管受侵情况及肿瘤可切除性的准确性.方法 选取2020年1月—2021年6月齐齐哈尔医学院附属第二医院收治的120例肝癌患者作为研究对象,分别于术前进行超声造影检查和彩色多普勒超声检查,对比评估不同检查方法对肝癌病灶血管受侵犯情况及临床的可切除性,以病理结果为金标准,分析两种检查的敏感性、特异性及准确率.结果 超声造影检查评估肝细胞肝癌血管侵犯的灵敏度为95.2％,特异度为94.3％,高于彩色多普勒超声检查的84.7％、74.3％,差异有统计学意义(χ2=11.414、10.636,P＜0.05);超声造影检查对肝癌病灶手术可切除性评价的准确率显著高于彩色多普勒超声检查,差异有统计学意义(χ2=10.678,P＜0.05).结论 应用超声造影技术能够准确评价肝细胞肝癌血管受侵情况,为肝癌病灶的手术切除方案的制定提供重要依据.

目的 探讨基于网络学习平台的慕课(massive online open courses,MOOC)联合翻转课堂教法的应用研究.方法 选取2019年3月—2021年3月齐齐哈尔医学院2016级影像203名专业学生作为对照组,应用传统授课教学法.选取200名2017级影像专业学生作为试验组,应用基于网络学习平台的慕课联合翻转课堂混合式教学法,对比分析两组影像专业学生的教学效果.结果 对比研究两种不同的教学方法,试验组影像专业学生超声思维能力评分(89.82±5.21)分,明显高于对照组的(82.31±6.12)分,差异有统计学意义(P＜0.05).试验组影像专业学生人文沟通能力评分(91.69±4.58)分,明显高于对照组的(81.43±5.91)分,差异有统计学意义(P＜0.05).试验组教师对学生学习情况的评价及学生对课堂教学效果的评价明显高于对照组,差异有统计学意义(P＜0.05).结论 在超声诊断教学中,基于网络学习平台的慕课联合翻转课堂教学法对教学效果的提高明显,不仅提高了影像专业学生的超声诊断能力、医患沟通能力,同时使学生的学习兴趣也得到了很大的提升.为培养优秀临床超声诊断医生打下了坚实基础,进一步促进了医学影像教育的快速发展.

目的 探讨基于慕课的翻转课堂教学法应用于影像实习教学的效果分析.方法 选取 2020 年 7 月—2022年 7 月来齐齐哈尔医学院附属第二医院实习的齐齐哈尔医学院 2016 级影像本科实习生 30 名作为对照组,对照组在实习期间给予传统教学法,选取 2017 级影像本科实习生 30 名作为试验组,试验组实习采用基于慕课的翻转课堂教学法,对比分析两组影像实习生的实习效果,以实践操作技能成绩、病例分析成绩、带教模式的满意度情况作为观察指标.结果 对比研究两种教学方法,实践操作成绩、病例考试成绩试验组均明显高于对照组,差异有统计学意义(P＜0.05);对比分析两组学生对实习带教的满意度,试验组结果明显高于对照组,差异有统计学意义(P＜0.05).结论 在影像实习带教中,应用基于慕课的翻转课堂教学法方对提高学生的成绩具有显著的效果,可以明显提高影像实习生的超声实践能力,更能有效提高影像实习生学习的主观能动性,对影像实习生临床综合素质的提高具有积极意义,同时影像实习生的教学满意度也得到了明显提高.

BACKGROUND:This study aimed to explore the specific pathogenesis of lncRNA MALAT1 promoting the invasion and metastasis of hepatocellular carcinoma (HCC) through peripheral blood vessels by regulating the expression of miRNA-613 molecule.METHODS:The data of 60 HCC metastatic patients and 60 HCC non-metastatic patients detected by the contrast-enhanced ultrasound (CEUS) in the Second Affiliated Hospital of Qiqihar Medical College from January 2020 to June 2021 were collected, as well as postoperatively retained HCC tissues and paired paracancer tissues (5 cm laterally from the edge of the cancer area), to study the changes of microangiogenesis in HCC tissues with CEUS. The correlation between CEUS grading and lncRNA MALAT1 in patients with HCC was analyzed through Pearson correlation analysis, lncRNA MALAT1 and miRNA-613 in HCC tissues of patients with HCC were detected by qRT-PCR, followed by the bioinformatic analysis for the relationship between lncRNA MALAT1 and miRNA-613. The Log-growing human HCC cell strain, HepG2, was selected for experiments. Adenovirus transfection knocked down lncRNA MALAT1 in HCC cells, which was divided into two groups (inhibitor-NC group and lncR-inhibitor group), followed by knocking down miRNA-613 on the basis of knocking down lncRNA MALAT1, which was divided into three groups (inhibitor-NC group, lncR-inhibitor groups, and lncR/miR613-inhibitor group). The expression of miRNA-613 and lncRNA MALAT1 in each group was detected by qRT-PCR. The migration and invasiveness of cells in each group were detected by Transwell assay.RESULTS:CEUS of HCC and Pearson correlation analysis showed that CEUS grading and lncRNA MALAT1 were positively correlated in patients with HCC. In HCC tissues of patients with HCC, lncRNA MALAT1 expressed high and miRNA-613 expressed low. The results of bioinformatic analysis showed the targeting of lncRNA MALAT1 and miRNA-613. Knocking down lncRNA MALAT1 could increase miRNA-613 expression significantly, and reduce the migration of HCC cells. Inhibiting miRNA-613 based on knocking down lncRNA MALAT1 could increase the survival and migration of HCC cells.CONCLUSIONS:lncRNA MALAT1 can promote HCC metastasis through the peripheral vascular infiltration by inhibiting the level of MiRNA-613, which can, therefore, be used as a potential target for the treatment of HCC.

介绍基于慕课的线上翻转课堂的教学特点,探讨基于慕课的线上翻转课堂教学法与传统教学法相比在超声诊断教学中应用的优势.该文结合超声诊断学的自身特点,总结分析基于慕课的线上翻转课堂教学法的教学效果.将教学过程分为课前准备阶段、课中实施阶段和课后评价阶段3个部分,课前运用慕课教学法,应用慕课平台引导学生课前进行自主预习,通过查阅资料,小组讨论等方式对相应知识点进行学习;课中运用翻转课堂教学法,使学生积极参与其中,与老师多元互动,激发学生学习兴趣,培养学生自主学习能力;课后评价采取理论知识考核评价、实践操作考试评价及学情调查问卷相结合,更能真实反映学生对知识的掌握水平和教学方法的应用效果.基于慕课的线上翻转课堂教学法的应用,在教学实践中取得了较好的效果.

目的 探讨基于慕课的线上翻转课堂结合TBL教学法在超声诊断教学中的应用.方法 选取2019年3月—2021年3月齐齐哈尔医学院在校的2016、2017级医学影像学专业本科生作为研究对象.选取2016级影像专业学生203名作为对照组,采用传统授课模式教学;选取2017级影像学专业学生200名作为研究组,研究组采用基于慕课的线上翻转课堂结合TBL教学法.比较两组学生的理论考试成绩、实践操作、学情满意度测评.结果 考试测验成绩显示,研究组学生医学影像学理论考试、实践操作、学情满意度测评明显高于对照组,差异有统计学意义(P<0.05).结论 基于慕课的线上翻转课堂结合TBL教学法不仅提高学生的理论成绩,还明显提高了学生的综合实践能力及学情满意度.

目的 探讨二次谐波超声造影术前检查肝癌血管受侵及肿瘤可切除性评价的使用价值.方法 选取2018年8月—2019年11月间我院收治的肝癌患者共200例,分别于术前采取二次谐波超声造影及CT增强扫描对患者进行检查,对比观察不同检查方法对周围血管受侵及手术可切除性的灵敏度、特异度等指标.结果 二次谐波超声造影术前分析肝癌周围血管受侵灵敏度及特异度与CT增强扫描对比差异无统计学意义(P>0.05);二次谐波超声分析手术可行性准确率与CT增强扫描对比差异无统计学意义(P>0.05).结论 二次谐波超声造影可于肝癌患者术前做出准确评价,指导手术方案.

目的 探究彩色多普勒超声检查胎儿动脉血流动力学指标对胎儿宫内窘迫预测价值.方法 选择2017年5月至2018年5月之间,在本院收治的胎儿窘迫孕妇65例作为观察组,另选取来本院正常妊娠孕妇共60例,采用彩色多普勒超声检查胎儿的脐动脉、大脑中动脉的血流变化情况,对比两组胎儿的血流变化特点以及比较彩色多普勒超声诊断胎儿宫内窘迫的准确性.结果 观察组胎儿脐动脉的Vs、Vd、RI、PI、S/D均和对照组胎儿血流指标差别显著(t=6.236、6.484、7.336、6.230、8.415),两者差异具有统计学意义(P<0.05);观察组胎儿大脑中动脉的Vs、Vd、RI、PI、S/D均和对照组胎儿血流指标差别显著(t=7.526、6.263、6.997、7.032、5.652),两者差异具有统计学意义(P<0.05);彩色多普勒超声技术诊断胎儿宫内窘迫的灵敏度为87.69％,特异度为81.67％,正确率84.80％.结论 彩色多普勒超声检查在检查胎儿方面具有安全性高、重复性强、操作简单方便等优势,并且检查胎儿血流动力学特点效果显著,可以准确的预测胎儿宫内窘迫的发生,同时有着较高的灵敏度和准确度,值得在临床推广使用.

目的:探讨超声三维斑点追踪技术联合磁共振心肌灌注成像对急性心肌梗死后心室重构的研究.方法:回顾性分析2015年6月至2017年7月期间本院门诊及住院收治的58例急性心肌梗死患者的超声影像资料,对比分析超声三维斑点追踪、磁共振心肌灌注成像单独及联合诊断对急性心机梗死后心室重构诊断的符合率.结果:超声三维斑点追踪技术联合磁共振心肌灌注成像对急性心肌梗死后心室重构诊断的符合率明显高于单独一种检查方法(P<0.05);58例急性心肌梗死后心室重构患者,超声造影检出符合率达92％,磁共振增强扫描检出符合率达88％,而两者联合诊断的检出符合率高达96％.结论:彩超声三维斑点追踪技术联合磁共振心肌灌注成像联合应用明显提高对急性心肌梗死后心室重构诊断的符合率.

目的 探讨经皮超声造影联合BI-RADS分级在乳腺癌诊断中的应用价值.方法 选择2015年6月-2016年12月因乳腺肿块就诊的患者76例,应用经皮超声造影联合BI-RADS分级进行检查,对比二者单独及联合应用的灵敏度、特异度、准确率等.结果 患者76个肿块,其中良性31个,恶性45个.超声造影、BI-RADS分级以及二者联合应用检查疾病灵敏度81.36％、81.97％、95.24％,特异度为70.59％、66.67％、92.31％,准确率为78.95％、78.95％、94.74％,联合应用灵敏度、特异度、正确率高于单纯超声造影、BI-RADS分级(均P＜0.05).结论 经皮超声造影联合BI-RADS分级能够提高乳腺癌诊断的灵敏度、特异度和准确率,降低漏诊率.

Objective:To investigate the value of three-dimensional vascular color power angio (3D-CPA) combined with real-time ultrasound elastography (RTE) in guidance and evaluation of curative effect on radiofrequency ablation (RFA) treatment of uterine fibroids.Methods: 45 patients with uterine fibroid (included 69 lesions) were divided into abundant vascularity group and scarce vascularity group according to blood flow detected by 3D-CPA in pre-operation. And patients of every group were further divided into low hypoechoic group, hyperechoic group and mixed echo group according to the echo situation of lesions. All of patients received examination of 3D-CPA and RTE in pre and post operation. And the real-time tissue elastic quantitative analysis technique of Q-analysis was used to analyze the hardness of uterine fibroids in pre and post treatment.Results: The differences of ablation time and ablation needle count between abundant vascularity group and scarce vascularity group were not statistically significant (t=-5.762,t=-6.782;P<0.05), respectively. Before patients received treatment of RFA, the strain rate (SR) of lesions in hypoechoic group was obviously lower than that in hyperechoic group which SR value was highest and mixed echo group which SR value was between in other two group. And the differences of SR value among three groups were statistically significant (F=7.784,P<0.05). For three kinds of lesions in three groups, the differences of SR value both of between pre and post RFA treatment 1h and between pre and post RFA treatment 3 months were statistically significant (F=8.075, F=6.872;P<0.05), respectively.Conclusion: Preoperative ultrasound combined with RTE can accurately assess the changes of uterine fibroids before and after RFA treatment so as to further achieve the dual evaluation for quantitative data and qualitative data of curative effect and prognosis outcome of patients.

Objective This paper aimed to investigate the application of the quantitative parameters of dynamic enhanced MRI (DCE-MRI), microvessel density (MVD) and microvessel density (VEGF) in the diagnosis of benign and malignant breast lesions. Methods A total of 128 patients who underwent DCE-MRI scans from March 2015 to July 2016 were enrolled in this study. The difference of quantitative parameters between benign group and malignant group was analyzed. The ROC curve was used to analyze the difference between benign and malignant group. Results There were significant statistical differences between the benign group and the malignant group. The specificity of Ktrans and Kep was 88.6%and 95.1%, respectively; the sensitivity of Ktrans and Kep was 87.9% and 68.7%, respectively. There was a strong correlation with MVD (r=0.597; 0.612) in the Ktrans and Kep values of breast cancer patients, there was a strong correlation between Ktrans and Kep (r=0.781; 0.763). Conclusion There is a strong correlation between the quantitative parameters of DCE-MRI and the pathological findings of MVD or VEGF, and it has a good effect in the diagnosis of benign and malignant breast lesions.

目的 探讨彩色多普勒超声造影联合磁共振增强扫描对肝脏结节性疾病的诊断效果分析.方法 回顾性分析2015年6月—2016年6月期间该院门诊和住院收治的102例肝脏结节病变患者的超声造影及磁共振增强扫描的检查资料,对比分析超声造影、磁共振增强扫描单独及联合诊断对肝脏结节性病变性质诊断的符合率.结果 彩色多普勒超声造影联合磁共振增强扫描对胆道梗阻性疾病诊断的符合率明显高于单独一种检查方法(P<0.05);102例肝脏结节性病变患者,超声造影检出符合率达88.24%,磁共振增强扫描检出符合率达95.09%,而两者联合诊断的检出符合率高达99.02%.对超声造影、磁共振增强扫描及联合诊断的病灶检出率与手术病理及穿刺活检证实符合率进行相关分析(r=0.960、0.986、0.995).结论 彩色多普勒超声造影与磁共振增强联合应用明显提高肝脏结节性病变性质的符合率.

目的 探讨利用超声网络教学平台中的"病例讨论模块",分析和评价其在超声课程教学中的有效性.方法 选取2011级和2012级影像本科学生作为研究对象.其中2011级学生86人为对照组,2012级学生90人为实验组.对照组采用传统的课堂授课,实验组应用超声网络教学数据库中"病例讨论模块"的参与教学模式,通过考试、问卷调查结果 来评价两种教学模式的效果.结果实验组在考试成绩、临床超声诊断能力、专业知识掌握能力、学习兴趣、沟通能力等方面均优于对照组,差异均具有统计学意义(P<0.05).结论 应用超声网络教学平台中的"病例讨论模块",医学生的专业素质、人文素质以及身心素质均有所提高.

目的 探讨PACS系统应用于医学影像专业学生提高实践技能的效果分析.方法 选取2015年7月—2016年7月齐齐哈尔医学院在该院影像科实习的120名医学影像系实习生,作为研究对象.将120名实习生分为研究组与对照组,每组60人,其中研究组基于PACS系统进行医学影像学教学,对照组学生接受传统授课模式教学,比较两组学生的理论考试成绩、阅片能力成绩及教学满意度测评.结果 考试测验结果 显示,研究组学生医学影像学理论考试成绩、阅片能力成绩及教学满意度明显高于对照组,差异均有统计学意义(P<0.05).结论 PACS系统在医学影像学教学中的应用,提高了教学质量,丰富了教学资源,提高了学生的学习兴趣,同时,学生通过接触更多的影像资料,还明显提高了学生的理论考试成绩、阅片能力及教学满意度.

目的 探讨磁共振胰胆管造影(MRCP)联合超声(US)对胆道梗阻性疾病的诊断效果分析.方法 回顾性分析2015年6月-2016年6月期间该院收治的68例胆道梗阻患者的MRCP及US检查资料,对比分析MRCP、US单独及联合诊断对胆道梗阻性疾病的检出率及病变性质的符合率.结果 MRCP联合US对胆道梗阻性疾病的检出率明显高于单独一种检查方法(P<0.05);68例患者中,MRCP、US及二者联合分别检出58例、55例、66例,检出率分别为85.29%、80.88%、97.05%.对MRCP、US及联合诊断的病灶检出率与手术证实符合率进行相关分析,r=0.98、0.966、0.995.结论 MRCP与US联合应用明显提高胆道梗阻性疾病的检出率及病变性质的符合度.