目的 探讨彩色多普勒超声在诊断2型糖尿病患者颈动脉粥样硬化性病变中的临床价值.方法 将131例2型糖尿病患者按微量尿白蛋白水平分为阳性组(70例)和阴性组(61例).采用彩色多普勒超声比较两组患者的颈动脉内-中膜厚度(IMT)、动脉斑块及狭窄等情况.结果 阳性组颈动脉IMT为(1.20 ±0.33)mm,明显高于阴性组的(0.97±0.24) mm;阳性组颈动脉粥样硬化斑块发生率为左侧38.6％(27/70)、右侧42.9％(30/70)、双侧30.0％ (21/70),阴性组颈动脉粥样硬化斑块发生率为左侧19.6％(12/61)、右侧21.3％(13/61)、双侧14.8％ (9/61);阳性组颈动脉狭窄发生率为左侧20.0％ (14/70)、右侧21.4％ (15/70)、双侧15.7％ (11/70),阴性组颈动脉狭窄发生率为左侧14.8％ (9/61)、右侧13.1％ (8/61)、双侧11.5％(7/61),阳性组明显高于阴性组(P＜0.05);阳性组24h尿蛋白排泄率(UAE)为(86.4±52.2)mg/d,明显高于阴性组的(15.4±6.8) mg/d,两组比较,差异有统计学意义(P＜0.05).阳性组患者颈动脉IMT厚度与UAE呈正相关(r=0.28,P＜0.05).结论 彩色多普勒超声可作为颈动脉粥样硬化和狭窄的诊断手段,对于UAE显著增高患者,颈动脉斑块形成风险显著增加.

目的分析甲状腺疾病的超声与CT检查表现,对比2种检查方式在甲状腺疾病诊断中的作用。方法回顾性分析在本院接受超声与CT检查并在本院经手术病理证实的83例甲状腺疾病患者资料,将超声、CT及联合检查结果与手术病理证实结果进行对比分析。结果超声诊断准确率为77.11%,CT诊断准确率为68.67%,超声联合CT诊断准确率为92.77%。结论超声与CT检查对于甲状腺疾病的诊断可以互补,临床诊断中联合应用可有效提高诊断的准确率,对临床治疗具有重要的参考作用。

目的 研究脑卒中患者出现低钾血症的情况并分析原因.方法 回顾性分析我院住院72例卒中患者,并以982例其他检查者作对照,比较低血钾发生几率,并依卒中严重程度、性质,呕吐、年龄分组,比较每种可能原因组中低钾血症情况.结果 重度脑损伤组和轻、中度脑损伤组低钾血症发生率分别是40%和24.3%,2组低钾血症发生率均比对照组显著高(P＜0.01或＜0.05),呕吐组和无呕吐组、脑梗死组和脑出血组、≤60岁和＞60岁组低钾血症发生率差异无统计学意义.结论 脑卒中程度越重,低钾血症发生率越高,低钾血症与卒中严重程度、呕吐、卒中性质和患者年龄有密切关系,需要进一步大样本、多中心研究证实.

目的:探讨氧化应激指标与维持性血液透析（MHD）患者早期动脉硬化的标志颈动脉内-中膜增厚的关系。方法:高频B超检测颈动脉内-中膜厚度,比较颈动脉内-中膜增厚组与正常组患者临床、生化指标及氧化应激指标丙二醛（MDA）、晚期氧化蛋白产物（AOPP）、抗氧化指标谷胱甘肽过氧化物酶（GSHPx）的含量;直线回归分析氧化应激指标与颈动脉内-中膜厚度的相关性;对颈动脉内-中膜增厚的危险因素进行多元回归分析。结果:颈动脉内-中膜增厚组患者年龄、舒张压、总胆固醇、血磷及MDA、AOPP水平明显高于正常组,颈动脉内-中膜增厚组GSHPx显著低于正常组。颈动脉内-中膜厚度与MDA、AOPP水平呈显著正相关,与GSHPx呈显著负相关。多元回归分析显示,年龄、AOPP、血磷是颈动脉内-中膜增厚的独立危险因素。结论:氧化应激是MHD患者早期动脉硬化表现颈动脉内-中膜增厚的重要原因之一。

患者女,25岁.因"发现左颌下肿物2个月"入院,查体:心肺未见异常,肝脾未触及,颈部不对称,颈软无抵抗,左颌下可见一肿物局限隆起,可触及肿物范围约为4 cm×2 cm×2 cm,囊性感,表面光滑,无结节,无触痛,边界清,可推动,不随吞咽及伸舌活动,甲状腺不大.颈部超声所见:甲状腺形态大小正常,内光点均匀,内未见明显异常回声;左颌下区于颌下腺下方可见一大小约为4.0 cm×1.5 cm混合性包块,边界清晰,其内回声不均,大部分为无回声区,小部分为较粗网格状光带(图1);左颈部大血管旁可见多个小低回声区,呈椭圆形,内回声均匀,其中见一大小约为1.3 cm×0.6 cm.

Objective To explore the validity of examining atherosclerotic plaques in carotid arteries by high-resolution B-mode ultrasonography and analyze its major risk factors in maintenance hemodialysis(MHD) patients.Methods Atherosclerotic plaques in carotid arteries were examined by high-resolution B-mode ultrasonography in 69 MHD patients.The clinical and biochemical findings were recorded.The related data in plaque positive group and plaque negative group were analyzed.Results Atherosclerotic plaques in carotid arteries were detected in 44.93%MHD patients.The difference in age ranges between two groups was significant(P0.05).The systolic blood pressure and levels of serum phosphate,cholesterol and C-reactive protein(CRP) were significantly higher in plaque positive group than in plaque negative group.Level of serum albumin was markedly lower in plaque positive group(P0.015).In Logistic multiple regression analysis,higher SBP and levels of serum phosphate and CRP were independent risk factors of atherosclerotic plaque formation in MHD patients.Conclusion B-mode ultrasonography can effectively detect atherosclerotic plaques in carotid arteries in MHD patients.High levels of CRP and serum phosphate and hypertension were independent risk factors of atherosclerotic plaques in carotid arteries in MHD patients.

他莫昔芬(Tamoxifen,TAM)是激素受体阳性乳腺癌术后内分泌治疗的首选药物,用药时间要求长,随着临床长期广泛应用,其潜在的妇科副作用越来越引起临床的重视.我们就2003-2007年观察的51例患者总结报告如下.

Objective To investigate the diagnostic value of ultrasonography in acute mammitis after injection augmentation mammoplasty.Methods We summed up the ultrasonographyic characteristics of lactation acute mammitis after injection augmentation mammoplasty.Results The manifestations on ultrasonic images of infectious features are visible in the retromammary space.Conclusion Ultrasongraphy has great diagnostic value and clinical significance in lactation acute mammitis of injection augmentation mamnoplasty.

目的:总结注射式隆乳术后哺乳期急性乳腺炎的诊治经验。方法:对15例注射式隆乳术后哺乳期急性乳腺炎患者的临床表现、辅助检查、治疗方法及结局进行回顾性分析。结果:注射式隆乳术后哺乳期急性乳腺炎的突出表现为患乳呈进行性增大,超声检查乳腺腺体层炎症表现不明显,而以乳腺后间隙改变表现为主。15例全作回奶治疗,11例需作切开引流,治疗时间为(12.9±4.4)d。结论:为预防有注射式隆乳术史孕妇发生哺乳期急性乳腺炎,做好其妊娠期保健及宣教十分重要,及时回奶是治疗的关键措施。

Objective:To study the diagnostic value and clinical significance of B-ultrasound examination in diagnosis of circular of umbilical cord.Methods:From Jan.2004 to April 2005,3200 uterogestation gravidas were examined by B-ultrasound.Results:883 cases of circular of umbilical cord were diagnosed by B-ultrasound examination prior to delivery,and 836 cases were confirmed after parturition.The incidence rate of circular of umbilical cord was 26.0% and the diagnostic accuracy was 94.6%.Conclusion:The diagnostic accuracy of B-ultrasound examination is high prior to delivery.B-ultrasound examination can provide reliable basis for clinicians to institute treatment plan and choose proper delivery style..It is necessary for uterogestation gravidas antepartum.

目的探讨中药川芎嗪对慢性阻塞性肺病急性发作期患者血浆内皮素(ET),一氧化氮(NO)的影响及治疗意义.方法将使用川芎嗪前、后患者血浆ET、NO含量分别与常规治疗前后患者及健康人作比较.结果肺心病患者ET增多,NO减少,使用川芎嗪后,ET含量回降幅度增大,NO含量增多,升幅显著大于常规治疗组.结论川芎嗪可促进慢性阻塞性肺病急性发作期血浆ET回降,促进NO产生,有助于减轻肺动脉高压.

应用高聚金葡素联合疑血酶治疗癌性胸水取得了较好的效果,现报道如下. 资料与方法:1995年至1998年间因恶性胸腔积液住院病例126例,其中男82例,女44例,平均年龄42岁.胸腔积液均由病理细胞学依据确诊(未作分类).随机分组:高聚金葡素组,共72例,其中男40例,女32例;顺铂组(对照组)54例,其中男29例,女25例.治疗组(高聚金葡素组)在细胞学确诊后即行闭式持续引流或胸穿抽液3～4次至胸液明显减少时,胸腔内注入NS 10ml+高聚金葡素5mg×4支+凝血酶2000u混合液,每天或隔天一次,共2～3次.顺铂组则向胸腔内注射顺铂60mg,隔天一次,共2～3次.所有病例未作全身化疗. 疗效判定:借助X线透视、B超、胸穿抽液及气促的症状改善情况判定胸腔积液的疗效.