目的：了解肾脏去神经（ RDN）对补肾中药抑制慢性肾功能不全致左心室肥厚的影响。方法38只SD大鼠随机分为对照组、腺嘌呤组、右归丸组、RDN组、右归丸＋RDN组，对照组6只，其余4组各8只。对照组、腺嘌呤组、右归丸组大鼠不予RDN术；RDN组、右归丸＋RDN组大鼠给予RDN术，术后1周开始灌胃给药。腺嘌呤组、右归丸组、RDN组、右归丸＋RDN组均灌胃腺嘌呤混悬液复制慢性肾功能不全大鼠模型；右归丸组以及右归丸＋RDN组另灌胃右归丸浓缩液；RDN组和对照组另灌胃等量生理盐水。12周后行超声心动图检查，测量室间隔（IVS）厚度、左心室舒张末期内径（LVEDD）、左心室后壁（LVPW）厚度、左心室收缩末期内径（LVESD）、左心室舒张末期容积（LVEDV）、左心室收缩末期容积（LVESV），计算左心室射血分数（LVEF），并取血检测肌酐（Cr）、尿素氮（UREA）、尿酸（UA）。结果12周后，腺嘌呤组、RDN组、右归丸组以及右归丸＋RDN组大鼠血清UREA、Cr水平均较对照组明显升高（ P＜0.01），前4组间血清Cr水平差异无统计学意义（ P＞0.05），右归丸＋RDN组大鼠血清UREA水平低于腺嘌呤组（ P＜0.05），腺嘌呤组、RDN组、右归丸组以及右归丸＋RDN组大鼠血清UA水平均高于对照组（P＜0.05，P＜0.01），但右归丸组以及右归丸＋RDN组大鼠血清UA水平明显低于腺嘌呤组（P＜0.05，P＜0.01）。12周后，腺嘌呤组大鼠IVS明显大于对照组（P＜0.01），LVPW虽大于对照组，但差异无统计学意义（ P＞0.05）， LVEDD、LVEDS、LVEDV以及LVESV均明显小于对照组（ P＜0.05）， LVEF大于对照组（P＜0.05）。12周后，RDN组大鼠各超声心动图参数与对照组及腺嘌呤组比较差异均无统计学意义（P＞0.05）。12周后，右归丸组大鼠IVS、LVPW均明显小于腺嘌呤组（P＜0.05，P＜0.01），LVEDD、LVEDV均大于腺嘌呤组（P＜0.01），但与对照组比较差异无统计学意义（P＞0.05）。12周后，右归丸＋RDN组大鼠LVEDD、LVEDV均大于腺嘌呤组（ P＜0.05），但与对照组比较差异无统计学意义（ P＞0.05）， IVS及LVPW明显大于右归丸组（ P＜0.05），但与腺嘌呤组比较差异无统计学意义（P＞0.05），IVS明显大于对照组（P＜0.01）。结论肾脏神经可能参与了右归丸抑制肾功能不全致左心室肥厚的作用。

Objective To investigate the effect of Youguiwan on the kidney ’ s mitogen-activated pro-tein kinase ( MAPK) signaling pathway and its roles on the ventricular hypertrophy in rats of chronic renal dys-function.Methods Specific-pathogen-free Sprague-Dawley rats were divided into three groups:control group ,adenine group ,Youguiwan group .The rats were administered adenine to induce chronic renal dysfunc-tion.Twelve weeks later , all of the rats were checked by ultrasonic cardiography , blood pressure was deter-mined used by Powerlab Data Acquisition System ,and blood sample were obtained for determining serum crea-tine,urea nitrogen and uric acid .The MAPK signaling proteins were determined by western blotting .Results Compared with rats of control group ,the serum urea nitrogen ,creatine and uric acid of adenine group and You-guiwan group were increased significantly(P<0.01 or 0.05).The interventricular septum(IVS)of adesine group was significantly greater than that of control group ( P<0.01) ,and the left ventricular end-diastolic di-mension(LVEDD),left ventricular end-systolic dimension(LVESD)and left ventricular end-diastolic volume (LVEDV),left ventricular end-systolic volume(LVESV)were significantly less than those of control group (P<0.05) .Both IVS and left ventricular posterior wall ( LVPW) of Youguiwan group were significantly less than those of adesine group(P<0.05 or 0.01),and both LVEDD and LVEDV were significantly greater than those of adesine group(P<0.01),but they were similar to those of control group (P>0.05).The systolic blood&nbsp;pressure ,diastolic blood pressure and mean blood pressure of rats in adesine group and Youguiwan group were significantly higher than those of control group (P<0.01 or 0.05).The kidney phospo-p38 protein in rats of adesine group was significantly higher than that of control group ( P<0.05) ,Youguiwan could significantly de-crease the level of phospo-p38 protein in the kidney .The kidney phospo-ERK1/2 protein in rats of adesine group was unsignificantly lower than that of control group ( P>0 .05 ) , but Youguiwan could significantly in-crease the level of phospo-ERK1/2 protein in the kidney .Conclusion Youguiwan could inhibit the left ven-tricular hypertrophy in rats of chronic renal dysfunction ,and it may be related to its regulation on the kidney phospo-p38 protein and phospo-ERK1/2 protein.

目的研究冠心病患者颈动脉粥样硬化的性别差异,为冠心病患者诊断和防治的性别差异提供依据。方法 209例经冠状动脉造影证实的冠心病患者按性别分为女性冠心病组和男性冠心病组。利用高频超声检测患者颈动脉内膜中层厚度与粥样斑块。登记患者年龄、体质指数(BMI)、血糖、血脂、血压与高敏C反应蛋白(hs-CRP)。结果女性冠心病组颈动脉内膜中层厚度小于男性冠心病组,女性冠心病组颈动脉斑块发生率也低于男性冠心病组,差异均有统计学意义(P<0.05)。女性冠心病组年龄、收缩压、脉压、TC和HDL-C大于男性冠心病组,差异有统计学意义(P<0.05)。女性冠心病组LDL-C小于男性冠心病组,差异有统计学意义。女性冠心病组和男性冠心病组间TG、FPG、2hPG、糖化血红蛋白、hs-CRP、BMI和舒张压差异均无统计学意义(P>0.05)。结论冠心病患者颈动脉粥样硬化存在性别差异,临床应用颈动脉超声检查指导冠心病诊治时必须考虑性别因素。冠心病患者颈动脉粥样硬化的危险因素也存在性别差异,提示冠心病的防治也需考虑性别的差异性。

目的探讨冠心病患者糖代谢状态对肱动脉内皮功能和颈动脉粥样硬化的影响。方法 209例冠心病患者按糖代谢状态分为糖代谢正常组、糖调节受损组和糖尿病组,利用高频超声检测其肱动脉内皮功能和颈动脉内中膜厚度与斑块,并记录患者年龄、性别、血压、血脂、血糖、hsCRP和肾功能资料。结果 3组间年龄、性别、血压、血脂差异无统计学意义。FPG、2hPG、糖化血红蛋白和hsCRP逐渐升高,差异有统计学意义,并且两两比较差异有统计学意义。3组间肱动脉内皮功能逐渐减低,颈动脉内中膜厚度逐渐增加,斑块发生率也度逐渐增加,差异均有统计学意义,并且两两比较差异有统计学意义。多元逐步回归分析表明颈动脉内中膜厚度的独立影响因素为年龄、FPG、2hPG、糖化血红蛋白、hsCRP和肱动脉内皮功能;肱动脉内皮功能的独立影响因素为年龄、FPG、2hPG、糖化血红蛋白和hsCRP。结论冠心病患者肱动脉内皮功能和颈动脉粥样硬化与糖代谢状态相关,hsCRP可能在其中起重要的介导作用。超声检查在评价冠心病患者糖代谢状态对肱动脉内皮功能和颈动脉粥样硬化的影响中具有重要作用。

Objective To investigate the protective effects of dexrazoxane on daunorubicin cardiotoxicity. Methods Patients with acute non-lymphoid leukemia were enrolled into chemotherapy group(Group A,12 cases) and dexrazoxane combined chemotherapy group(Group B,10 cases).ECG and evaluation of ejection fraction(EF) were carried out after each course of chemotherapy. Results After the 1st course of chemotherapy,the incidences of ECG abnormal were 25.0%(3/12) and 10.0%(1/10) in the Group A and B,respectively.Meanwhile,incidences of EF reduced by more than 10% were 16.7%(2/12) and 10.0%(1/10) in Group A and B,respectively.No significant difference was revealed between the two groups.After the 3rd course of chemotherapy,the incidences of abnormal ECG were 50.0%(6/12) and 20.0%(2/10) in Group A and B,respectively.Meanwhile,the incidences of EF reduced by more than 10% were 41.7%(5/12) and 20.0%(2/10) in Group A and B,respectively.There were significant differences between the two groups(P<0.01).Patients with abnormal ECG and reduced EF for more than 10%(8 and 7 cases,respectively) were subsequently treated with 2 courses of dexrazoxane.Recovery of ECG and EF was observed in 5 and 4 patients,respectively without recurrence. Conclusion Dexrazoxane confers cardiac protection against daunorubicin cardiotoxicity and reverses daunorubicin-induced heart injury.

Objective To investigate the influence of Chinese patent medicine Shuxuetong on the prognosis and endothelial function and cardiovascular event in acute coronary syndrome(ACS) patients.Methods 60 ACS patients with significant coronary artery stenosis lesion of coronary artery were randomly divided into two groups, the control group and the experiment group. The control group were given standard drug therapy(follow the guidelines of ACS)after the PCI implantation;The experiment group were given Shuxuetong, based on the treatment of the control group. Before treatment, and 10 days after the treatment, the changes in flow-mediated dilation(FMD) inbrachial artery detected through high-resolution ultrasonography, the levels of serum endothelins:ET1、TXB2、6-keto-PGF were tested,and at the same time, the incidences of unstable anginapectoris and acute myocardial infarction, and mortality during the periods of hospitalization were compared between the two groups.Results It was significantly higher in FMD (P0.05)and significantly lower in ET1(P0.05)、TXB2(P0.05) level in the experimental group than that in the control group after 10 days’ treatment. There was also a significant difference in 6-ketoPGF between the two groups(P0.05); and a significant difference was found between the beginning and 10 days after treatment in both groups (P0.05). Within the periods of hospitalization the incidences ofunstable anginapectoris and acute myocardial infarction, and mortality seems to be higher in the experimental group than that in the control(P=0.04) .Conclusions PCI implantation may has the temporary damage to endothelial function of the patients with acute coronary syndrome(ACS);Shuxuetong can significantly raise FMD and reduce the level of ET1、TXB2 in acute coronary syndrome(ACS) patients, and also seems to improve the prognosis of them.

Objective To explore the meaning of fetus's ventricle echo (EIF) in the high-risk and the low-risk focus when appeared isolatedly or combined with other floppy appearances. Methods A total of 3344 cases that had no obvious unwonted configuration fetus were devided into high-risk group and low-risk group,and were analyzed according to the risk and the EIF appearance,partly using the pursuing method and the chromosome karyotype analyzing to account the detection rate of the EIF and the unwonted chromosome. Results The detection rate of EIF in the fetus of high-risk group was higher than that of the low-risk group,and same in the unwonted chromosome. In 22 cases with EIF of the high-risk group,19 cases with EIF were isolated,including 2 cases of unwonted chromosome,and 2 cases were diagnosed unwonted chromosome in the left 3 cases with EIF combined other ultrasound floppy sign. In 50 cases with EIF of the low-risk group,46 cases with EIF were isolated and had no case unwonted chromosome,and 1 case was diagnosed unwonted chromosome in the left 4 cases with EIF combined other ultrasound floppy sign. Conclusion The isolated EIF in the low-risk group has no significant clinical meaning,but in the high-risk group does,and it must be analyzed based on many-sided clinical data and treated cautiously. In cases of EIF combined with multinomial ultrasound floppy sign,whether in the high-risk or the low-risk group,the fetus may have many affinities with the unwonted chromosome,and analysis of the chromosome karyotype is suggested.

Objective To investigate the structure and function of carotid artery in patients with myocardial infarction with high-frequency ultrasound.Methods The carotid artery of 40 patients with myocardial infarction and 30 normal controls were exam- ined with high-frequency ultrasound.The intima-media thickness(IMT),end-systolic diameter(Ds)and end-diastolic diameter (Dd)were measured with two-dimensional ultrasound.The brachial artery systolic and diastolic pressure were measured to calculate the Ep,βand AC.Results The IMT was thicker in the myocardial infarction subjects than in the control subjects(P0.05).The Ds and Dd were larger in the myocardial infarction subjects than in the control subjects(P0.05).The Ep,βwere higher while AC was lower in myocardial infarction subjects than in the control subjects(P0.05).Conclusion IMT combined with Ep,βand AC can provide the characteristics of structure and function changes of carotid artery.

目的了解广州市健康体检人群胆囊息肉(PLG)发生情况,及其与脂肪肝和总胆固醇升高的关系。方法对2006年5-12月到某医院体检中心体检的人员进行空腹血糖、肝功能、血脂的测定,B超检查肝、胆状况。按不同年龄、性别及PLG的发生等情况分组进行统计分析。结果共有9750人参加健康体检,检出PLG261例,发生率为2.68%;其中男性PLG发生率3.02%(159/5263),女性PLG发生率为2.27%(102/4487)。各年龄组的男性和女性的PLG发生率比较差异均有统计学意义(均P<0.05);不同年龄组的男性和女性的PLG发生率比较差异也均有统计学意义(均P<0.01)。男性和女性的PLG者的脂肪肝、总胆固醇升高的发生率均明显高于无PLG者(均P<0.01)。结论广州市部分健康体检者PLG发生率男性高于女性,发生率亦随着年龄的增长而上升;PLG者的脂肪肝、总胆固醇升高的发生率明显高于无PLG者。

Objective:To investigate the altertions of structure and function of carotid artery in diabetic patients by high-frequency ultrasound so as to provide an effective and helpful information for the diagnosis as well as preventive treatment for diabetes complicated with atherosclerosis of carotid artery.Methods:The carotid artery of both 70 diabetic patients and 35 subjects as normal control group were examined by high-frequency ultrasound.2-dimentional ultrasound was used to observe the intima-media thickness(IMT) and to measure the dimeter of systolic and diastolic period,and to calculate the Ep,β and AC.Results:The IMT was larger in the diabetic patients than that in the control subjects(P0.05).The systolic diameter and diastolic diameter were larger in the diabetic patients than in the control subjects(P0.05).There were higher Ep,β and lower AC in diabetic patients(P0.05).Conclusion:This study demonstrates that many indices observed by high-frequency ultrasound can reveal the structure and function changes of carotid artery and may be a convenient and effective modality to evaluate carotid artery atherosclerosis.

目的探讨阻塞性睡眠呼吸暂停综合征(OSAS)患者以及阻塞性睡眠呼吸暂停综合征合并心血管病患者的血管内皮功能、颈动脉内膜中层厚度(IMT)及斑块的变化及相互关系。方法对24例OSAS患者分为单纯OSAS组11例及OSAS合并合并心血管病患者组13例,20例健康对照组采用高分辨超声检测肱动脉基础动脉内径(D0)、内皮依赖性血流介导的舒张功能(FMD)、非内皮依赖性硝酸甘油介导的舒张功能(NID)、颈动脉超声检测颈动脉内膜中层厚度和斑块。结果OSAS合并心血管病组的FMD,NID均低于单纯OSAS组及对照组(P<0·05);而单纯OSAS组的FMD,NID亦均低于对照组(P<0·05);OSAS合并心血管病组的IMT和颈动脉粥样斑块检出率明显高于单纯OSAS组及对照组(P<0·01)。结论OSAS患者存在内皮功能紊乱,OSAS合并心血管病者内皮功能紊乱更严重,同时伴IMT增厚及劲动脉粥样硬化斑块检出率增加。

Objective To investigate the relationship between left ventricular hypertrophy and carotid artery function in diabetic patients by ultrasonography.Methods A total of 70 diabetic patients and 35 healthy subjects underwent high-resolution ultrasonography to detect carotid artery buffering function.Results Ep and β in diabetic patients were higher than that of in control group(P<0.05).AC in diabetic patients was lower than that in control group(P<0.05).Ep and β was increased and AC was decreased more seriously in diabetes patients with LVH than that in diabetes patients without LVH.There was positive correlations between left ventricular mass index(LVMI) and Ep,β,there was positive correlations between LVMI and AC.Conclusion Left ventricular hypertrophy relates with carotid artery buffering dysfunction in diabetes patients.The carotid artery buffering dysfunction might play an important role in development and progression of left ventricular hypertrophy in diabetes patients.

目的:探讨舒张性心力衰竭(DHF)患者血清BNP价值及左室功能相关性。方法:将100例患者分为3组,心功能正常组30例,DHF组40例和CHF组30例。应用多普勒超声心动图检测患者左室功能的多项指标并同时测定该患者血浆脑钠素(BNP)的浓度。结果:(1)DHF组和CHF组的血浆BNP水平均显著高于心功能正常组,DHF组的血浆BNP水平显著高于DHF组(P<0.01);(2)DHF组的E/A比值与正常组比较差异有统计学意义(P<0.01);(3)心衰患者血浆BNP水平与LAD、LVD、呈显著正相关(P<0.001);与EF、FS、E/A呈显著负相关(P<0.001)。结论:利用血清BNP浓度的检测和应用多普勒超声对左室舒张功能不全患者进行诊断是安全、简便、有效的方法。血清BNP的浓度与超声检查的结果有良好的相关性。

Objective To explore the relative factors of OSAS occurrence,measure the basic clinical data of patients with OSAS,and compare with the results of control group.To investigate the affect of OSAS on endothelial function,the aim is to have a better understand of the role of OSAS in cardiovascular diseases and likely mechanism.Methods To examine polysomnography(PSG)in the snore persons.Measure the basic clinical data such as neck perimeter,abdomen perimeter,BMI,blood pressure,blood glucose,triglyceride(TG),cholesterol,to analyze relative factors of OSAS occurrence,and compare above data with control groups'.With color doppler ultrasongraph,to measure OSAS patients' heart,carotid and humeral artery inner diameter,after reactive hyperaemia and nitroglycerin administration,humeral artery inner diameter,calculate inner diameter change rate,compare with the results of control group,to explore its main affect and evaluate endothelial function in patients with OSAS.Results Compared basic clinical data between OSAS group with control group,OSAS group have a significant increasing sBP,dBP,TG,BMI,abdomen perimeter,neck(jugular)perimeter.In the OSAS group,patients' AHI was correlated with neck(jugular)perimeter,BMI,TG,sBP,dBP,correlative coefficients were 0.398,0.431,0.490,0.413,0.44 respectively.Compared with control group,OSAS group had a increasing right ventricular Dd,IVS,pulmonary artery diameter.Between two groups,there were no significant difference on basic brachial artery(humeral artery)inner diameter,but were significant difference of inner diameter change rate in two groups after reactive hyperaemia and nitroglycerin administration.The main factors affect humeral artery inner change rate were age,BMI,jugular perimeter,TG,sBP,dBp,were correlative coefficient.Conclusion OSAS impair patients' endothelial function,and related to age,BMI,jugular perimeter,TG,sBP,dBp.Obesity(increasing BMI,abdomen perimeter,jugular perimeter)is related to OSAS' pathogenesis,hypertension and high TG are related to the disease.AHI was correlated with neck(jugular)perimeter,BMI,TG,sBP,dBp.OSAS group had a increasing right ventricular Dd,IVS,pulmonary artery diameter.

大鼠眼部及其周围组织详细结构未见文献的详细报道或描述,我们在超声介导放射性微粒植入近距离治疗眼部肿瘤研究这一课题项目中,发现大鼠的眼部组织解剖结构与人类大有不同.在动物实验中,研究其组织解剖结构及手术穿刺针的安全进路及出血表现,这些实验材料,未见既往有文献报道.

目的应用异丙酚,水合氯醛,氯胺酮等三种常用动物实验麻醉药对小白鼠的麻醉效果比较分析。研究三种麻醉药对小白鼠的致死量,麻醉起效时间及麻醉维持时间。方法随机采购实验动物养殖基地实验用健康小白鼠200只,每只体重约50g,使用市售异丙酚,水合氯醛,氯胺酮三种麻醉药对小白鼠分组、分批不同剂量注射麻醉,观察记录麻醉后的各种数据。结果异丙酚,水合氯醛,氯胺酮三种常用动物实验麻醉药对小白鼠的麻醉效果不同。其麻醉致死量、麻醉起效时间、麻醉维持时间差异有统计学意义。结论麻醉对动物实验成功与否起关键作用,采用正确的麻醉剂量是动物实验成功的先决条件。

With the times of digital and information,the traditionary teaching of ultrasound diagnostics had not adapt the need of times development.This articles introduces the application of PACS(picture archiving and communication systems) to the teaching of ultrasound diagnostics from the structure of PACS,advantages and disadvantages,and application prospect.

目的:探讨运用高频超声检测颈动脉内中膜厚度及粥样斑块与冠心病的关系.方法:运用高频超声检测对照组与冠心病组的颈动脉内中膜厚度及有无粥样斑块.结果:冠心病组内中膜厚度及粥样斑块发生率高于对照组.结论:运用高频超声检测颈动脉内中膜厚度及粥样斑块与冠心病间存在良好相关性.

1　病例 　　患者女性，40岁,平素体健，无任何临床症状，12年前顺产一健康男孩，本次健康检查、体格检查及实验室检查未发现异常。B超检查：双肾区未探及肾脏声像。经腹部及背部广泛检查后于盆腔内探及双肾声像，轮廓清，偏小，左肾9.3 cm×3.3 cm，右肾7.8 cm×3.3 cm，表面平滑，实质回声低匀，厚约1.4 cm，肾窦显示清晰，排列规则，内未见强光团及分离暗区(图1)。双肾位置不随体位改变而变化。B超诊断：双侧盆腔异位肾，超声号：2000101。X线静脉肾盂造影：双侧盆腔异位肾，X线号：344516。