ObjectiveTo explore the significance of quantitative parameters of tissue diffusion included in the real-time ultrasound elastography (RTE), in diagnosing the degree of liver fibrosis. MethodFrom July 2012 to November 2014, liver biopsy being the gold standard for evaluating hepatic fibrosis stage, we performed RTE on 112 hepatitis patients and analyzed the elastogram we got. At the same time, we carried out quantitative analysis of tissue diffusion in these patients, and obtained the values of liver fibrosis index (LFI) of right liver parenchyma. Subsequently, we compared the biopsy pathological results with the values of LFI, and single-factor analysis of variance (ANOVA) was adopted to compare the LFI among patients with variant degrees of liver fibrosis. If there were any discrepancies, least significant difference method would be adopted in order to compare one with the other from different groups. Finally, critical value of LFI of different-stage liver fibrosis was obtained with the help of receiver operator characteristic (ROC)curve. ResultsChronological liver fibrosis was classified into stage 0, stage 1, stage 2, stage 3, and stage 4, and their LFI values were 2.36±0.46, 2.38±0.45, 2.84±0.54, 3.16±0.59, and 3.69±0.55, respectively. ANOVA showed that the LFI values of different-stage fibrosis had significant differences (F=29.959, P<0.001). However, there was no difference between stage 0 and stage 1 (P=0.920), or between stage 2 and stage 3 (P=0.076). The area under the ROC curve for stage 0-1 and stage 2-3, stage 2-3 and S4 was respectively 0.784 and 0.799, and their critical value was 2.83 and 3.69 respectively. ConclusionsThe real-time ultrasound elastography is a feasible and non-invasive method in diagnosing the degree of hepatitis fibrosis and LFI has advantage in distinguishing different stage of liver fibrosis.
目的 探讨重症急性胰腺炎(SAP)早期治疗模式。方法 分析我院ICU建成前、后收治的SAP病例资料，对比ICU组和非ICU组的住院时间、后期并发症、死亡率、死亡原因等。结果 ICU组抢救成功率明显提高（92.1% vs 54.8%），P＜0.05。结论 以 ICU为中心的综合治疗模式，能提高SAP抢救成功率。
Quantitative analysis of ultrasound molecular imaging is of great significance for clinical diagnosis and research. Based on Visual Studio development platform and C# language, this paper designs a set of ultrasound molecular imaging region of interest quantitative analysis software, which can complete the ultrasound image scaling processing, rectangular and arbitrary shape of the region of interest capture, mark saving and loading, gray value quantitative analysis and so on. In this paper, the function of the software is described in detail and the software is tested and verified. It is proved that the software can quantitatively analyze the conventional ultrasound images and ultrasound contrast images, which can provide a basis for the relevant research on the quantitative analysis of the gray value of ultrasound molecular imaging.
ObjectivesTo investigate the ultrasound findings of the synovial hemangioma of knee (SHK) and to evaluate its value in clinical diagnosis.MethodsThe ultrasonographic manifestations and clinical data of 10 patients with SHK confirmed by surgery and pathology were retrospectively analyzed and compared with MRI findings, surgery and pathological results.ResultsSeven cases of SHK (6 cases of diffuse type, 1 case of limited type) were assessed by ultrasound, including 1 case of vascular origin, 1 case of supraorbital sac origin, 1 case with pigmented villonodular synovitis, 1 case with thrombosis, 2 cases accompanied with bone erosion and osteophyte formation, and 3 cases with joint cavity effusion. Ultrasonic findings of SHK were as followed: 7 cases of SHK were manifestate as diffuse mass with unclear boundary, irregular shape and uneven echo mass; 5 cases had mixed-echo mass with reticular structures inside, an increased volume in erect position and positive CDFI compression test; 1 case had heterogeneous hypoechoic mass with a nodular appearance and the positive compression test; 1 case as poorly-demarcated, irregular shape, heterogeneous hyperechoic mass without obvious blood flow signals under the compression test. There were no characteristic ultrasonic findings from other 3 cases of SHK.ConclusionsDiffuse SHKs have characteristic ultrasonograms. SHKs with localized and significant synovial hyperplasia have no specific ultrasonic manifestation and are easily misdiagnosed. Ultrasound is convenient, noninvasive and inexpensive. It can accurately evaluate the involvement of knee joint capsule and surrounding soft tissues. It can be used as the first line diagnostic modality for routine scanning of SHKs.
Purpose To investigate the status of proliferation and activation of vascular endothelial cells in preretinal neovascular membranes from patients with insulin dependent diabetetes mellitus(IDDM)by means of immunohistochemical techniques. Methods Status of vascular endothelial cells in 18 preretinal neovascular membranes from 18 patients with IDDM was studied by double-immunofluorescence technique and the alkaline phosphataes-anti-alkaline phosphatase(APAAP)technique and compared the findings with the main clinical features of the patients. Results Of 18 vascularized membranes,16(88.9%)contained proliferating endothelial cells (positive for proliferating vascular endothelial cell marker EN 7/44) and 14 (77.8%) were positive for endothelial cell activation marker anti-VCAM-1;furthermore,by using a double staining technique,we found that in 14 of the 16 cases(87.5%) the proliferating vascular endothelial cells were activated (expressing VCAM-1). Conclusion The proliferation and activation of the vascular endothelial cells of the newly formed vessels in preretinal neovascular membranes suggests the significance of the vascular endothelial cells in the pathophysiology and the progress of proliferative diabetic retinopathy. (Chin J Ocul Fundus Dis,1998,14:141-143)
ObjectiveTo systematically review the model and mechanism, efficacy and its influencing factors of the promotion and application of appropriate health technology in China. MethodsSuch database as VIP, CNKI, CBM and WanFang Data were electronically searched to collect studies on the promotion and application of appropriate health technology in China published from the establishment dates to January 2013. According to the inclusion and exclusion criteria, two reviewers independently screened literature, extracted and cross-checked data, and assessed quality. Qualitative synthesis method was used to systematically summarize the included studies. ResultsA total of 73 studies were finally included. Targeted populations included primary medical staff and personnel who provided or developed appropriate health technologies, medical institutions and their managers, as well as patients who received service or treatment of appropriate health technology. The promotion of appropriate health technologies mainly contained five fields: Chinese medicine, biomedicine, family planning services, maternal and child health, and community health services. The government-leading model had been widely applied currently, besides, there were other four models: government-guidance, government-driven, market-leading and a third sector-leading models. Factors related to project funding, organization and management, technology holders, the supply and demand parties in technical services and technology itself might affect the application of appropriate health technology. Among all evaluation studies, the number of needs assessment was less, the contents of process evaluation were one-sided and the effect evaluation was mainly cross-sectional studies. ConclusionThis study shows that sustainable development of appropriate health technology promotion model need to fully consider market demand and people's needs, on the basis of using government-leading or introducing a third sector-leading model. Corresponding measures should be taken according to the influencing factors of promotion and application of appropriate health technology. It is necessary to conduct high quality evaluation studies in future and comprehensively evaluate the efficacy of the promotion and application of appropriate health technology.
To evaluate the ultrasound imaging characteristics and diagnostic criteria for acute abdominal Meckel's diverticulum disease (MD), we retrospectively analyzed the ultrasonic characteristics, clinical data of 58 cases of pathologically proved MD from January 2009 to May 2012. We found that among all the 58 patients, 21 patients were diagnosed with the preoperative clinical diagnosis of MD. Fourteen cases of MD inflammation with acute appendicitis were evaluated by pathological examinations after the surgery. We also found 4 cases of MD with perforation, 15 cases of MD with intussusceptions, 14 cases MD with intestinal obstruction, 5 cases of MD secondary to intestinal obstructionor intestinal necrosis, and 5 cases of MD without any obvious complications. Emergency ultrasound examinations revealed 8 cases of simple MD, 1 case of MD with intussusceptions, 9 cases of MD with acute appendicitis, 12 cases of MD with intestinal obstruction, 2 cases of MD with intussusceptions and intestinal obstruction, 1 case of MD with omphalocele and 1 case of MD with abdominal abscess. The emergency sonographic findings suggested that MD was relatively fixed bowel or thick-walled cystic mass, with one end connected to small intestine, and the other end connected to the blind side, at the periumbilicus region or at the lower right abdomen. A conclusion could be drawn that MD is difficult to be detected by ultrasound (detection rate was about 15.5%), and MD with complications such as intussusceptions, intestinal obstruction, acute appendicitis can usually be more easily detected (detection rates were 24.1%, 24.1% and 15.5%, respectively). Sonography is a simple, effective way to make diagnosis and differential diagnosis of MD with different acute abdomen symptoms from other disease.
Gallbladder polypoid lesion (GPL) is a common gallbladder disease, mainly including tumor lesions such as gallbladder cancer and gallbladder adenoma and non-tumor lesions such as cholesterol polyps and gallbladder adenomyomatosis. Contrast-enhanced ultrasound (CEUS) can improve the diagnostic accuracy of GPL. This paper reviews the application progress of CEUS in the diagnosis of gallbladder cancer, gallbladder adenoma, gallbladder cholesterol polyps and gallbladder adenomyosis, and the limitations of CEUS in the diagnosis of GPL.
【摘要】 目的 探讨外周血管动静脉瘘的超声特征及其鉴别诊断。 方法 回顾性分析2003年1月-2010年3月间收治的36例先天性及后天性动静脉瘘患者的临床资料，使用彩色超声诊断仪观察受累血管的内径、血管壁的连续性，根据血流动力学变化寻找瘘口；对受累血管血流频谱进行分析，并与健侧对照。 结果 18例先天性动静脉瘘查见纡曲扩张的血管网，无法辨认瘘口；18例后天性动静脉瘘全部可显示瘘口，2例合并静脉破裂的为囊瘤型，其余后天性动静脉瘘均为洞口型。受累动脉近心端血流为高速低阻型，全部患者受累静脉出现动脉样血流，近心端静脉呈高速低阻型频谱；10例患者远心端静脉内出现逆向离心血流。 结论 引流静脉出现高速、动脉样血流频谱是动静脉瘘的特征性表现；先天性动静脉瘘可见异常血管网，不能辨认瘘口；后天性动静脉瘘均可显示瘘口。彩色超声多普勒检查对动静脉瘘能够正确诊断及鉴别诊断。【Abstract】 Objective To observe characteristic imaging of arteriovenous fistulas (AVF) of periphery vessel, and to evaluate the differential diagnosis of AVF by ultrasonography. Methods Thirty-six patients suffering from congenital and acquired AVF in this hospital from January 2003 to March 2010 were selected to undergo Doppler ultrasonography. The blood flow of arteriovenous fistulas, diameter, morphology and blood flow characters of affected vessels were observed. Spectral of fistula and affected vessels were analyzed and compared with the healthy side. Results Deformed vascular net was observed, and the localization of arteriovenous fistulas was not observed directly in 18 congenital AVF patients.Inversely the localization of arteriovenous fistulas was observed directly in 18 acquired AVF patients.Two acquired AVF patients with venous rupture belonged to kystoma form, and others acquired AVF patients belonged to orifice form.Spectral analysis of proximal arteries of the fistula revealed high velocity and low resistance.Arterialized flow pattern was observed in affected veins.Proximal veins of the fistula revealed arterialized spectral with high velocity and low resistance.Reversed blood flow was observed in the distal veins of the fistulas in 10 patients. Conclusion Arterialized flow with high velocity in veins are characteristic signs of AVF.Deformed vascular net is observed, and the localization of arteriovenous fistulas in not observed directly in congenital AVF patients, but the localization of arteriovenous fistulas is observed directly in acquired AVF patients.Color Doppler ultrasonography has great value in confirming diagnosis and differential diagnosis of AVF.