目的观察针刺联合输卵管通液术治疗气滞血瘀型输卵管炎性不孕的临床疗效及对血清基质金属蛋白酶-9(matrix metalloproteinase-9,MMP-9)、基质金属蛋白酶抑制剂-1(tissue inhibitor of metalloproteinase-1,TIMP-1)水平的影响。方法将69...目的观察针刺联合输卵管通液术治疗气滞血瘀型输卵管炎性不孕的临床疗效及对血清基质金属蛋白酶-9(matrix metalloproteinase-9,MMP-9)、基质金属蛋白酶抑制剂-1(tissue inhibitor of metalloproteinase-1,TIMP-1)水平的影响。方法将69例气滞血瘀型输卵管炎性不孕患者随机分为针刺组(34例)和假针组(35例)。针刺组给予针刺联合输卵管通液术治疗;假针组给予输卵管通液术后针刺组穴位旁开1 cm非经非穴处进针,只刺破皮肤,不行针治疗。观察两组治疗前后中医证候和体征积分、输卵管通畅度及血清MMP-9和TIMP-1水平、MMP-9/TIMP-1比值变化,并比较两组中医证候、体征疗效及随访6个月内宫内妊娠率。结果假针组治疗后中医证候积分未见改变(P>0.05),针刺组治疗后低于治疗前和假针组(P<0.01)。两组治疗后体征积分降低(P<0.01),输卵管通畅情况呈现不同程度改善(P<0.05),血清MMP-9水平增高(P<0.01),血清TIMP-1降低(P<0.01),MMP-9/TIMP-1比值升高(P<0.01);针刺组治疗后优于假针组(P<0.01,P<0.05)。针刺组宫内妊娠率高于假针组(P<0.05)。结论针刺联合输卵管通液术治疗气滞血瘀型输卵管炎性不孕疗效显著,作用机制可能与升高MMP-9水平,降低TIMP-1水平,调节二者比值从而抑制纤维化过程有关。展开更多
目的探讨剪切波弹性成像技术(Shear Wave Elastography,SWE)结合甲状腺结节超声恶性危险分层中国指南(Chinese Thyroid Imaging Reporting and Data System,C-TIRADS)在甲状腺结节鉴别诊断中的价值。方法回顾性分析176例甲状腺结节患者,...目的探讨剪切波弹性成像技术(Shear Wave Elastography,SWE)结合甲状腺结节超声恶性危险分层中国指南(Chinese Thyroid Imaging Reporting and Data System,C-TIRADS)在甲状腺结节鉴别诊断中的价值。方法回顾性分析176例甲状腺结节患者,共179个结节,其中良性结节78个,恶性结节101个。小结节(≤10 mm)77个,大结节(>10 mm)102个。以粗针穿刺或手术病理结果为“金标准”,分析常规超声C-TIRADS分类诊断、SWE及两者联合诊断与“金标准”的一致性,绘制受试者工作特征曲线,分析常规超声C-TIRADS分类诊断、SWE及两者联合诊断的诊断效能。结果良性结节杨氏模量最大值(SWE_(max))、最小值(SWE_(min))、平均值(SWE_(mean))、标准差(SWE_(SD))均小于恶性结节,差异有统计学意义(P<0.05);恶性大、小结节的SWE_(max)、SWE_(mean)、SWE_(min)、SWE_(SD)值均大于良性大、小结节的各杨氏模量值,差异有统计学意义(P<0.001)。C-TIRADS指南诊断敏感度、特异性、准确度、曲线下面积(Area Under Curve,AUC)、Kappa值分别为97.03%、60.26%、81.0%、0.786、0.597;SWE诊断敏感度、特异性、准确度、AUC、Kappa值分别为89.11%、87.18%、88.3%、0.881、0.762;两者联合诊断的Kappa值、敏感度、特异性、准确度、AUC分别为0.874、99.01%、88.46%、94.4%、0.937。结论恶性大、小结节杨氏模量值均大于良性大、小结节的杨氏模量值。SWE与C-TIRADS指南联合诊断甲状腺结节可进一步提高敏感度、特异性、准确度,可应用于临床实际工作中。展开更多
The Xiejiaba and Fuqiangbei plutons form part of the newly identified Neoproterozoic Niushan complex,which is located in the southern South Qinling belt(SQB).The plutons are compositionally similar,were emplaced at 75...The Xiejiaba and Fuqiangbei plutons form part of the newly identified Neoproterozoic Niushan complex,which is located in the southern South Qinling belt(SQB).The plutons are compositionally similar,were emplaced at 750–711Ma,and provide insights into Neoproterozoic tectonism within the South Qinling belt.The Xiejiaba pluton contains diorite,quartz diorite,granodiorite,and granite phases,all of which are sub-alkaline and have variable major element compositions with negative correlations between SiO_(2)and MgO,TFe_(2)O_(3),Al_(2)O_(3),CaO,TiO_(2)and P_(2)O_(5).These rocks are enriched in light rare earth elements(LREEs)and large ion lithophile elements(LILEs)and have negative Nb,Ta,P and Ti anomalies,all of which are indicative of arc-type magmatism.The Fuqiangbei pluton contains granitoids that are compositionally similar to the rocks in the Xiejiaba pluton.Samples from these plutons have similarε_(Nd)(t)values(1.24–5.99)but very variable(^(87)Sr/^(86)Sr)i values(0.7010–0.7054).Combining these data with the geochemical data for these rocks suggests that the magmas that formed the Niushan complex were derived from the crust–mantle boundary.This,combined with the results of previous research,suggests that the transition from low pressure-low temperature to low pressure-high temperature conditions within a subduction zone caused melting during a period of late subduction and backarc extension.This constrain the timing of subduction within the South Qinling belt and the northern Yangtze Block(YB)to 750–711 Ma,with this Neoproterozoic subduction associated with an ocean to the north overprinting an existing continental rift-type tectonic setting within the northern margin of the Yangtze Block and the South Qinling belt.展开更多
文摘目的探讨剪切波弹性成像技术(Shear Wave Elastography,SWE)结合甲状腺结节超声恶性危险分层中国指南(Chinese Thyroid Imaging Reporting and Data System,C-TIRADS)在甲状腺结节鉴别诊断中的价值。方法回顾性分析176例甲状腺结节患者,共179个结节,其中良性结节78个,恶性结节101个。小结节(≤10 mm)77个,大结节(>10 mm)102个。以粗针穿刺或手术病理结果为“金标准”,分析常规超声C-TIRADS分类诊断、SWE及两者联合诊断与“金标准”的一致性,绘制受试者工作特征曲线,分析常规超声C-TIRADS分类诊断、SWE及两者联合诊断的诊断效能。结果良性结节杨氏模量最大值(SWE_(max))、最小值(SWE_(min))、平均值(SWE_(mean))、标准差(SWE_(SD))均小于恶性结节,差异有统计学意义(P<0.05);恶性大、小结节的SWE_(max)、SWE_(mean)、SWE_(min)、SWE_(SD)值均大于良性大、小结节的各杨氏模量值,差异有统计学意义(P<0.001)。C-TIRADS指南诊断敏感度、特异性、准确度、曲线下面积(Area Under Curve,AUC)、Kappa值分别为97.03%、60.26%、81.0%、0.786、0.597;SWE诊断敏感度、特异性、准确度、AUC、Kappa值分别为89.11%、87.18%、88.3%、0.881、0.762;两者联合诊断的Kappa值、敏感度、特异性、准确度、AUC分别为0.874、99.01%、88.46%、94.4%、0.937。结论恶性大、小结节杨氏模量值均大于良性大、小结节的杨氏模量值。SWE与C-TIRADS指南联合诊断甲状腺结节可进一步提高敏感度、特异性、准确度,可应用于临床实际工作中。
基金supported by the National Natural Science Foundation of China(Grant No.41872219)the Key Research and Development Program of Shaanxi(Grant No.2019SF-245)+1 种基金the Natural Science Foundation of Shaanxi Province(Grant No.2023-JC-YB-222)an integrated research project of Integrated Exploration of China Geological Survey(Grant No.WKZB1911BJM300369/002)。
文摘The Xiejiaba and Fuqiangbei plutons form part of the newly identified Neoproterozoic Niushan complex,which is located in the southern South Qinling belt(SQB).The plutons are compositionally similar,were emplaced at 750–711Ma,and provide insights into Neoproterozoic tectonism within the South Qinling belt.The Xiejiaba pluton contains diorite,quartz diorite,granodiorite,and granite phases,all of which are sub-alkaline and have variable major element compositions with negative correlations between SiO_(2)and MgO,TFe_(2)O_(3),Al_(2)O_(3),CaO,TiO_(2)and P_(2)O_(5).These rocks are enriched in light rare earth elements(LREEs)and large ion lithophile elements(LILEs)and have negative Nb,Ta,P and Ti anomalies,all of which are indicative of arc-type magmatism.The Fuqiangbei pluton contains granitoids that are compositionally similar to the rocks in the Xiejiaba pluton.Samples from these plutons have similarε_(Nd)(t)values(1.24–5.99)but very variable(^(87)Sr/^(86)Sr)i values(0.7010–0.7054).Combining these data with the geochemical data for these rocks suggests that the magmas that formed the Niushan complex were derived from the crust–mantle boundary.This,combined with the results of previous research,suggests that the transition from low pressure-low temperature to low pressure-high temperature conditions within a subduction zone caused melting during a period of late subduction and backarc extension.This constrain the timing of subduction within the South Qinling belt and the northern Yangtze Block(YB)to 750–711 Ma,with this Neoproterozoic subduction associated with an ocean to the north overprinting an existing continental rift-type tectonic setting within the northern margin of the Yangtze Block and the South Qinling belt.
