眼表超声雾化、睑板腺镊按摩及聚乙二醇滴眼联合治疗MGD相关干眼的临床研究

目的:分析眼表超声雾化+睑板腺镊按摩+聚乙二醇滴眼液治疗睑板腺功能障碍(MGD)相关干眼的临床效果。方法:选取在成都市龙泉驿区第一人民医院眼科门诊2019年7月至2021年6月首次就诊的80例MGD相关干眼患者作为研究对象,根据随机数字表法将患者分为对照组[40例(80眼),热敷+手指睑板腺按摩+聚乙二醇滴眼液治疗]和观察组[40例(80眼),眼表超声雾化+睑板腺镊按摩+聚乙二醇滴眼液治疗],比较不同方案的临床效果。结果:治疗4周后,相比于对照组,观察组患者眼表疾病指数问卷(OSDI)评分、角膜荧光素染色评分、睑脂排出能力评分、睑板腺分泌物性状评分较低,泪膜破裂时间较长,差异具有统计学意义(P<0.05);两组患者治疗过程中均未发生严重眼部并发症;观察组患者治疗总有效率为95.00%,较对照组的80.00%更高,差异具有统计学意义(P<0.05)。结论:眼表超声雾化、睑板腺镊按摩及聚乙二醇滴眼液联合治疗MGD相关干眼,可确切改善眼部不适相关症状,促进睑板腺功能提升,恢复泪液正常分泌,保证临床治疗效果,且联合方案安全性较高。

中药眼表超声雾化结合综合护理治疗干眼症的疗效观察

探究对干眼症患者采取中药眼表超声雾化及综合护理的效果。方法 从2022.11-2023.11本院接诊的干眼症患者中选出70例,应用数字分组法,完成后分别设置为对比组(35例、人工泪液联合常规护理)、探究组(35例、中药眼表超声雾化联合综合护理)。所有患者均接受综合护理,比较临床疗效。结果 探究组症状评分更低,治疗有效率及患者满意度(97.14%、94.29%)相较于对比组(85.71%、88.57%)更高,护理及生活质量评分更高,(P<0.05)。结论 针对干眼症患者,联合采取中药眼表超声雾化及综合护理干预方案,有助于干眼症临床症状的改善,在提升疗效、患者满意度、生活质量等方面均具有积极作用。

超声评分量表在分娩前胎盘植入类型预测诊断中的应用

目的:探讨超声评分量表在分娩前胎盘植入类型预测诊断中的应用价值。方法:选取经临床证实为胎盘植入患者26例作为研究对象,回顾性分析临床资料。结果:26例患者均经术后病理证实为子宫瘢痕部位胎盘植入,分娩前经腹超声检查中应用超声评分量表评估,结果提示胎盘植入26例,其中粘连型20例,植入型4例,穿透型2例;根据患者术后临床及病理结果提示胎盘植入26例,其中粘连型23例,植入型2例,穿透型1例;提示胎盘植入的超声诊断符合率为100%,各类型预测符合率为粘连型86.9%、植入型50%、穿透型50%。结论:超声评分量表在分娩前超声检查中的应用,有助于明确胎盘植入的诊断,并且能够较好的预测胎盘植入不同类型,以指导后续临床治疗。

血友病性关节超声评估量表评分与其临床功能评分的相关性研究

目的探讨血友病性关节超声评估量表(HEAD-US-C)评分与其临床功能评分的相关性。方法采用HEAD-US-C评分对40例男性血友病患者的240个膝、肘、踝关节进行超声评分,并采用血友病性关节健康评估表(HJHS)2.1版及功能独立性评分表(FISH)对其关节临床功能情况进行评估。根据凝血因子缺乏的类型将40例血友病患者分为A型32例和B型8例,比较不同类型血友病患者HEAD-US-C评分、HJHS评分、FISH评分;分析HEAD-US-C评分与HJHS评分、FISH评分间的相关性。结果40例患者共240个关节,HEAD-US-C评分为22.50(8.00,30.50),HJHS评分为31.50(15.50,46.75),FISH评分为27.00(21.50,32.00)。不同类型血友病患者间的HEAD-US-C评分、HJHS评分、FISH评分比较差异均无统计学意义。40例血友病患者HEAD-US-C评分与HJHS评分呈正相关(r=0.884,P<0.001),与FISH评分呈负相关(r=-0.825,P<0.001)。结论HEAD-US-C评分与HJHS评分和FISH评分均有较好的相关性,可以客观评估血友病患者关节损伤情况,为临床提供参考信息。

基于RS485的超声波能量表与上位机间的通信

在太阳能-地源热泵耦合系统中,为了实现RS485设备与上位机间的通信,并在Win CC中实时读取超声波能量表的各参数,利用USB-485转换器实现PC机与能量表间的数据传输,并利用OPC服务器Kepware使数据通过Win CC中的OPC通道在上位机中实时显示。文中详细介绍了能量表与上位机间的通信原理、通信过程及调试结果,结果显示系统所需要的参数均能在上位机中实时读取。经过实际测试,设计稳定可靠,能够实现超声波能量表与上位机间的通信。

超声多参数评分量表对颈动脉狭窄患者颈动脉支架植入术或颈动脉内膜剥脱术不良转归事件的预测价值

目的:研究超声多参数评分量表对颈动脉狭窄患者颈动脉支架植入术或颈动脉内膜剥脱术不良转归事件的预测价值。方法:以进行颈动脉支架植入术或颈动脉内膜剥脱术的颈动脉狭窄患者150例为研究对象,将术后1年发生再狭窄、脑卒中或者死亡等不良转归事件的患者纳入转归不良组(35例),将转归良好的患者纳入转归良好组(115例)。比较两组患者术前3 d及术后1个月的超声多参数评分量表评分。比较两组患者不稳定性斑块积分比、斑块最大偏心比、斑块溃疡、斑块最大长度、斑块最大厚度、斑块面积狭窄率、血管重构、僵硬指数、狭窄处峰值流速以及阻力指数。采用Logistic回归分析颈动脉狭窄患者颈动脉支架术或颈动脉内膜剥脱术转归不良的危险因素。采用受试者工作特征(ROC)曲线分析超声多参数评分量表对不良转归事件的预测价值。结果:术前3 d,两组患者超声多参数评分量表评分比较差异无统计学意义(P>0.05)。术后1个月,两组患者超声多参数评分量表评分均显著升高,且转归良好组患者评分显著高于转归不良组(P<0.05);另外,转归良好组患者改善率优于转归不良组(P<0.05)。转归良好组患者不稳定性斑块积分比、斑块最大偏心比、斑块最大长度、斑块最大厚度、斑块溃疡、斑块面积狭窄率、血管重构、僵硬指数、狭窄处峰值流速以及阻力指数优于转归不良组(均P<0.05)。Logistic回归分析显示,不稳定性斑块积分比、斑块最大偏心比、斑块最大长度、斑块最大厚度、斑块溃疡、斑块面积狭窄率、血管重构、僵硬指数、狭窄处峰值流速以及阻力指数是造成患者不良预后的危险因素(均P<0.05)。ROC曲线分析显示,超声多参数评分量表预测不良转归事件的截断值为10.5分,曲线下面积为0.905,敏感度为88.10%,特异度为86.77%,约登指数为0.744。结论:超声多参数评分量表对颈动脉狭窄患者颈动脉支架植入术或颈动脉内膜剥脱术不良转归事件的具有良好的预测价值。

超声结合临床特征评分量表在喀什地区前置胎盘评估处理中的应用价值

目的 探讨超声结合临床特征评分量表在前置胎盘术前评估及处理中的应用价值。方法 选取2019年1月至2020年6月喀什地区第二人民医院,喀什地区泽普、莎车、叶城、巴楚县人民医院分娩的137例前置胎盘患者的临床资料进行研究和分析。根据超声结合临床特征的评分量表,确定预测产后出血及子宫切除的临界分值。按评分将患者分为A组(<5分)、B组(5~8分)、C组(≥9分),对各组的年龄、体质量指数(BMI)、妊娠次数、剖宫产次数、出血量、输血量、住院天数、母儿并发症等情况进行分析。结果 5分、6分、9分是预测产后出血、严重产后出血(出血量≥2000 mL)和子宫切除的临界值。超声结合临床特征评分值与出血量呈正相关(r=0.737,P<0.05)。三组年龄、怀孕次数、剖宫产次数、前置胎盘类型比较,差异有统计学意义(P<0.05),而BMI、分娩孕龄、超声胎盘厚度等比较,差异无统计学意义(P>0.05);在出血量、输血量、子宫切除数及手术时间上C组(≥9分)最高(P<0.05),急诊手术率比较,差异无统计学意义(P>0.05)。三组在住院时间、术后住院时间和入ICU时间上C组(≥9分)最高(P<0.05),新生儿Apgar评分比较,差异无统计学意义(P>0.05)。结论 术前进行超声结合临床特征评分能有效预测产后出血、子宫切除等风险,5分是预测产后出血的临界值,9分是预测子宫切除的临界值。新的评分量表能够预测前置胎盘的出血风险,对于减少产后出血相关并发症,改善妊娠结局有重要作用。

腹部及浅表超声检查前注意事项

超声是一种以超声波为基础的医学影像诊断技术,临床将该种诊断技术应用至疾病观察中具有显著疗效,它可以更加直观地显示肌肉、内脏器官的大小、病情状况以及器官结构等,进而帮助临床对疾病作出准确诊断,不仅可以提升疾病检查效果,而且对后续疾病的治疗具有积极意义。因此,超声波检测在临床工作中具有重要作用。但调查研究结果显示,多数患者对超声检查前的相关注意事项一无所知,在一定程度上影响了疾病检查准确性,那么在进行腹部及浅表超声检查前有哪些基本注意事项呢?

超声在阑尾炎急症中的应用

目的分析探讨超声在阑尾炎急症中的应用价值。方法选取我院在2015年5月至2017年6月所收治的80例经手术病理、治疗追踪证实的阑尾炎急症患者作为研究对象,对其临床资料及超声诊断资料进行回顾性分析,探讨超声在阑尾炎急症中的应用价值。结果所有患者均经超声检查,其中急性单纯性阑尾炎患者26例,相应诊断符合率为89%;化脓性阑尾炎患者33例,相应诊断符合率为96%;坏疽性阑尾炎患者14例,相应诊断符合率为94%;阑尾周围脓肿并腹膜炎患者7例,相应诊断符合率为91%。结论超声诊断在阑尾炎急症中的应用价值显著,其能及时对阑尾炎急症作出准确客观的诊断,从而有助于为临床诊断及选择治疗方案提供准确可靠的依据,是阑尾急诊工作中极为可靠的检查手段,因而具有较为广阔的临床应用价值。

白内障超声乳化人工晶体植入术治疗青光眼术后32例临床观察

目的:评价表麻下透明角膜切口白内障超声乳化人工晶体植入治疗抗青光眼术后白内障患者的临床疗效。方法:采用表麻下颞侧透明角膜切口超声乳化人工晶体植入治疗抗青光眼术后白内障患者32例36眼,术后第1、7、30、90、180 d观察视力、眼压、滤过泡的情况,并与术前对比。结果:术后视力明显提高,眼压较稳定,滤过泡无明显损伤,并发症较少。结论:该手术能提高患者的视力,保护滤过泡的功能,较好维持术后眼压。

新型超声量表评估次大面积肺栓塞的可行性研究

目的探讨新型超声量表评估次大面积肺栓塞的应用价值。方法回顾分析2017年9月至2019年6月于哈尔滨医科大学附属第二医院经计算机断层肺血管造影(CTPA)确诊为急性肺栓塞患者137例,选取77例作为实验集,其余60例作为验证集。依据2019年欧洲心脏病学会(ESC)肺栓塞指南分为次大面积肺栓塞组(sub-PE组,71例)和小面积肺栓塞组(small-PE组,66例)。应用统计学方法在实验集中筛选出有意义的超声参数制成超声量表,再运用量表对验证集患者进行评分,绘制ROC曲线,评估新量表对sub-PE的诊断效能。结果①一般情况:sub-PE组较small-PE组年龄稍大[(61.57±1.45)岁对(56.31±1.59)岁,P=0.016],其余一般资料数据两组间差异无统计学意义(均P>0.05)。②实验集:77例肺栓塞患者中sub-PE组41例与small-PE组36例。与small-PE组相比,sub-PE组右室前后径、肺动脉主干内径、右室/左室比值、三尖瓣反流速度、Tei指数、下腔静脉内径明显增大(均P<0.05),而右室前壁运动幅度、右房面积变化率、右室面积变化率、三尖瓣环收缩期位移、下腔静脉塌陷率以及肺动脉血流加速时间明显减小(均P<0.05);通过实验集筛选出15项超声参数制成超声量表。③验证集由每组各30例组成,sub-PE组较small-PE组分值显著增加(11.63±3.87对4.43±1.96,P<0.001);应用新型超声量表诊断sub-PE的ROC曲线下面积为0.96,以6.5为截断值时敏感性为90.00%,特异性为83.33%。结论新型超声量表为临床评价sub-PE提供一种综合可行的超声影像学方法。

正清风痛宁注射液电致孔导入辅助治疗强直性脊柱炎肌腱端炎57例

目的:观察正清风痛宁注射液电致孔导入辅助治疗强直性脊柱炎肌腱端炎的临床疗效。方法:选取强直性脊柱炎患者57例,予非甾体类抗炎药、改善病情类抗风湿药、调节骨代谢、活血化瘀药物并配合电致孔跟腱导入正清风痛宁注射液治疗,15 d为1个疗程。治疗前后对患者的跟腱末端肌腱厚度、局部肌腱端VAS评分、Bath AS疾病活动指数(BASDAI)进行对比评估,并观察记录治疗期间出现的不良反应。结果:正清风痛宁能减轻肌腱端炎,减少滑囊内积液,减少异常血流信号。结论:正清风痛宁注射液电致孔导入治疗强直性脊柱炎肌腱端炎疗效明显。

Characterization of focal liver lesions with SonoVue~-enhanced sonography: International multicenter-study in comparison to CT and MRI

AIM： To evaluate in a multicenter study whether the sonographic characterization of focal liver lesions can be improved using SonoVue-enhancement; and to compare this method with computed tomography （CT） and magnetic resonance imaging （MRI）. METHODS： One hundred and thirty four patients withone focal liver lesion detected in baseline ultrasound （US） were examined with conventional US, contrastenhanced US （n = 134）, contrast-enhanced CT （n = 115） and/or dynamic contrast-enhanced MRI （n = 70）. The lesions were classified as malignant, benign or indeterminate and the type of lesion was determined. The final diagnosis based on the combined information of all imaging examinations, clinical information and histology （n = 32） was used. Comparisons were made to see whether the addition of contrast-enhanced US led to the improvement of the characterization of doubtful focal liver lesions.RESULTS： In comparison with unenhanced US, SonoVue markedly improves sensitivity and specificity for the characterization （malignant/benign） of focal liver lesions. In comparison with CT and/or dynamic MRI, SonoVue -enhanced sonography applied for characterization of focal liver lesions was 30.2% more sensitive in the recognition of malignancy and 16.1% more specific in the exclusion of malignancy and overall 22.9% more accurate. In the subgroup with confirmative histology available （n = 30）, sensitivity was 95.5% （CEUS）, 72.2% （CT） and 81.8% （MRI）, and specificity was 75.0% （CEUS）, 37.5% （CT） and 42.9% （MRI）. The sensitivity and specificity of CEUS for the identification of focal nodular hyperplasia （FNH） and hemangiomas was 100% and 87%, resulting in an accuracy of 94.5%.CONCLUSION： SonoVue-enhanced sonography emerges as the most sensitive, ost specific and thus most accurate imaging modality for the characterization of focal liver lesions.

Value of contrast-enhanced intraoperative ultrasound for cirrhotic patients with hepatocellular carcinoma:A report of 20 cases

AIM： To assess the clinical value of contrast-enhanced intraoperative ultrasound （CE-IOUS） as a novel tool in partial hepatectomy for cirrhotic patients with hepatocellular carcinoma （HCC）. METHODS： From January 2007 to September 2007, a total of 20 consecutive cirrhotic patients with HCC scheduled to undergo partial hepatectomy were studied. Preoperative contrast enhanced computer tomography （CT） and/or magnetic resonance （MR） scans were performed within 1-2 wk before operation. Intraoperative ultrasound （IOUS） and CE-IOUS were carried out after mobilization of the liver. Lesions on precontrast and postcontrast scans were counted and mapped. CE-IOUS was performed with intravenous injection of ultrasound contrast agents SonoVue （Bracco Imaging, Milan, Italy）. Arterial, portal and late phases of contrast enhancement were recorded and analyzed. Nodules showing arterial phase hyper-enhancing and/or hypo-enhancing in late parenchymal phase were considered malignant and removed surgically. Ultrasound-guided biopsy and ethanol ablation would be an option if the nodule could not be removed surgically. Newly detected nodules on IOUS showing iso-enhancement in both arterial and late phases were considered benign. These nodules were either removed surgically if they were close to the main lesion or followed by examinations of alpha-fetoprotein （AFP） level and ultrasound and/or CT/MR every 3 too. RESULTS： IOUS found 41 nodules in total, among which 17 （41.46%） were newly detected compared to preoperative imaging. Thirty-three nodules were diagnosed malignant by CE-IOUS, including one missed by IOUS. The sensitivity and specificity of CE-IOUS on detecting HCC nodules are 100% （33/33 and 100% （9/9）, respectively. Nine nodules were considered benign by CE-IOUS, four was confirmed at histology and five by follow-up. CE-IOUS changed the surgical strategy in 35% （7/20） of patients and avoid unnecessary intervention in 30% （6/20） of patients. CONCLUSION： CE-IOUS is a useful means to characterize the nodules detected by IOUS in cirrhotic liver, to find isoechoic HCC nodules which can not be shown on IOUS and to improve the accuracy of conventional IOUS, thus it can be used as an essential tool in the surgical treatment of cirrhotic patients with HCC.

Differentially Expressed Proteome of Microcystis under Short-time Ultrasonic Stress

This study was conducted to explore the regulation mechanism for key protein expression. The Microcystis treated by short-time ultrasonic wave was select-ed to analyze the total protein based on 2-DE. The results showed that there were 71 up-regulated protein spots, 56 down-regulated protein spots, 54 new protein spots and 21 protein spots disappeared under short-time ultrasonic stress. Eight dif-ferential proteins were chosen for further MALDI-TOFTOF/MS analysis, and the re-sults showed that 2 unknown proteins and 6 functional proteins were detected. These proteins were relevant to some physiological processes, such as antioxidation and anti-inflammatory process, phosphate synthesis and electron transfer, which is beneficial to the metabolic balance and self-protection under short-time ultrasonic stress.

Local recurrence is an important prognostic factor of hepatocellular carcinoma

AIM： To clarify the importance of complete treatment by PELT. METHODS： A total of 140 previously untreated cases of HCC were enrolled in this study from 1988 to 2002. The inclusion criteria were： a solitary tumor less than 4 cm in diameter or multiple tumors, fewer than four in number and less than 3 cm in diameter, without extrahepatic metastasis or vessel invasion. As general principles for the treatment of HCC, the patients underwent transcatheter arterial chemoembolization （TACE） prior to PEIT. After the initial treatment of the patients, ultrasonography and computed tomography were performed, and measurement of serum levels of α- fetoprotein （AFP） was determined. When tumor recurrences were detected, PEIT and/or TACE were repeated whenever the hepatic functional reserve of the patient permitted. We then analyzed the variables that could influence prognosis, including tumor size and number, the serum levels of AFP, the parameters of hepatic function （albumin, bilirubin, ALT, hepaplastin test, platelet number, and indocyanine green retention at 15 rain [ICG-R15]）, combined therapy with TACE, distant recurrence, and local recurrence. RESULTS： Univariate analysis identified the ICG test, serum levels of AFP and albumin, tumor size and number, and local recurrence, but not distant recurrence, as significant prognostic variables. In multivariate analysis using those five parameters, the ICG test, tumor size, tumor number, and local recurrence were identified as significant prognostic factors. In both univariate and multivariate analyses, the relative risk for the ICG test was the highest, followed by local recurrence. CONCLUSION： We found that local recurrence is an independent prognostic factor of HCC, indicating that achieving complete treatment for HCC on first treatment is important for improving the prognosis of patients with HCC. 2005 The WJG Press and Elsevier Inc. All rights reserved.

Diagnostic approach to patients with acute idiopathic and recurrent pancreatitis,what should be done?

Acute recurrent pancreatitis (ARP) is a common clinical condition that may be difficult to diagnose. Endoscopic ultrasound (EUS) is proposed to be a safe first line test of choice in the majority of patients. When interventions are needed to remove biliary stones, evaluate sphincter of Oddi or pancreas divisum, endoscopic retrograde cholangiopancreatography (ERCP) is recommended. Magnetic resonance cholangiopancreatography (MRCP) can be a suitable alternative from a diagnostic standpoint although may not be widely available. Finally, genetic testing is increasingly used to detect certain mutations that are associated with this diagnosis.

Laser ultrasonic technique for surface defects detection of 6061 aluminum alloy

In order to estimate and detect the surface defect depth of metals, the transmission method of laser ultrasonic surface waves is used in this work. The laser ultrasonic detection platform taking use of thermoelastic mechanism as acoustic signal excitation method and interference receiver as acoustic signal receiver method was built, by which B-scan images of detected specimens with surface defects were collected to establish the relationship between the transmission coefficient and depth of the surface defect. Experimental results show that the amplitude of transmitted acoustic signal is related to the depth of surface defect. At last, a fitted curve of transmission coefficient using measured experimental data is obtained to estimate depth of surface defect on the 6061 aluminum alloy. Furthermore, a surface defect depth of 0.3 mm is estimated by the fitting curve with an estimated error of 16%. Therefore, a experimental method using the transmission method by laser ultrasonic is presented in this paper.

Extrahepatic portal vein aneurysm: Two case reports of surgical intervention

We report two cases of extrahepatic portal vein aneurysm,and both of them underwent surgical intervention. The first case had a mild pain in right upper quadrant of the abdomen; the second had no obvious symptoms. Physical examination revealed nothing abnormal. Both of them were diagnosed by magnetic resonance imaging angiography (MRA). One of the aneurysms was located at the main portal vein, the other, at the confluence of the superior mesenteric vein and the splenic vein, and these two places are exactly the most common locations of the extrahepatic portal vein aneurysm reported in the literature (30.7% each site). The first case underwent aneurysmorrhaphy and the second case, aneurysm resection with splenectomy. Both of them recovered soon after the operation, and the symptom of the first case was greatly alleviated. During the follow-up of half a year, no complication and adverse effect of surgical intervention was found and the color Doppler ultrasonography revealed no recurrence of the aneurysmal dilation. We suggest that surgical intervention can alleviate the symptom of the extrahepatic portal vein aneurysm and prevent its complications effectively and safely for low risk patients.