目的 探讨彩色多普勒超声诊断膀胱破裂的诊断价值,以提高膀胱破裂的超声诊断水平。 方法 回顾性分析2002年1月－2011年9月术前行彩色超声检查诊断膀胱破裂并经手术证实的5例患者资料，下腹加压检查和经导尿管注水试验检查作为超声判断有无膀胱破裂的重要检查方法。 结果 5例均为腹膜外型膀胱破裂,彩色多普勒血流显像明确诊断4例，漏诊1例，超声检查是诊断膀胱破裂的有效方法。 结论 彩色多普勒超声可以作为膀胱破裂的首选检查技术。Objective To investigate the value of color doppler flow image (CDFI) in diagnosing bladder rupture, in order to promote the ultrasound diagnosis for the disease. Methods We retrospectively analyzed the medical data of 5 patients with bladder rupture diagnosed by CDFI before operation and confirmed by surgery. Pressing the lower abdomen and injecting water through catheter were the main examination methods for CDFI in diagnosing bladder rupture. Results All the 5 cases were bladder rupture of extraperitoneal type. Four were diagnosed with CDFI, and 1 was misdiagnosed. The ultrasonic examination was an effective technology in diagnosing bladder rupture. Conclusion CDFI may be regarded as the first diagnostic technology for bladder rupture.
The pathogenesis of diabetic retinopathy is complicated. The vast network of multiple factors including unifying mechanism, inflammatory reaction, neuron degeneration and metabolic memory of glucose, and the four established pathogenic molecular pathways are hotspots of mechanism research for diabetic retinopathy. Nevertheless, these researches may be only one corner of the ldquo;icebergrdquo; of DR mechanism, and we still face enormous challenges in DR mechanism research. Collaboration with multiple disciplines to study the relationship between DR and diabetes and other systemic diseases, search novel therapy targets may increase the result in an unexpected windfall for DR basic research.
Objective To evaluate the diagnostic value of Em18 by enzyme-linked immunosorbent assay (ELISA) in the patients with alveolaris echinococcosis (AE). Methods We searched MEDLINE, EMBase, PubMed, The Cochrane Library, and other databases to collect the studies which evaluated the diagnostic value of Em18 in the patients with AE. QUADAS items were used to evaluate the quality of the included studies. The heterogeneity of the included studies and meta-analyses was analyzed by using RevMan 4.2.10. The Summary Recevier Operating Characteristic (SROC) curve was performed by meta-disc. Results Eight studies involving 409 patients with AE diagnosed by the gold standard, 1105 patients with other diseases, and 216 healthy people were included. Meta analyses showed that the pooled sensitivity and pooled specificity of purified Em18 in ELISA were 91.5% and 91.7%, and those of recombinant Em18 were 92.2% and 95.7%, respectively. The AUC of SROC of purified Em18 and recombinant Em18 were 0.966 6 and 0.978 9, respectively. Conclusion Purified Em18 and recombinant Em18 have high value in diagnosis of AE by ELISA.
Objective To explore the actual experience of epileptic patients in video electroencephalogram (VEEG) examination, and to provide reference basis for formulating corresponding nursing strategies and coping methods. MethodsIn this descriptive analysis study, 18 patients (11 males and 7 females, average age 37.78±18.7 years) receiving VEEG from January to April 2022 in the Second Affiliated Hospital of Guangzhou Medical University, underwent a semi-structural interview. Information obtained from the interview was analyzed using the Colaizzi 7-step method. ResultsThe actual experience of epileptic patients in video EEG examination can be summarized into two aspects: the medical experience and the need for nursing care. The medical experience includes positive and negative experience. The positive experience includes good service attitude, professional medical services, good endurance, and being hopeful. The negative experience includes a weird feeling in the head, insomnia, inconvenience in life, eye discomfort, psychological pressure, and pain. The need for nursing care includes needs for knowledge, strong needs for communicating with doctors, needs for humanistic care and female needs for female implementing the equipment. Conclusion Epileptic patients suffer from different degrees of discomfort and psychological pressure during VEEG examination. Both negative and positive experience exist. Medical staff should improve the content of nursing services according to the nursing needs of patients and provide professional VEEG examination services to patients.
目的 评价微创椎弓根钉内固定技术治疗胸腰椎爆裂骨折的中期临床疗效。 方法 2002年9月－2007年9月，采用微创椎弓根钉内固定技术治疗胸腰椎爆裂骨折30例。其中男16例，女14例;年龄18～65岁，平均39.8岁。骨折节段:胸11者3例， 胸12者13例， 腰1者12例， 腰者22例。所有骨折按AO分型，均为A3型。受伤至手术时间6 h～6 d，平均45 h。分析术后影像学指标、疼痛评分及功能障碍指数。 结果 患者均获随访，随访时间3～9年，平均5.2年。术后各时间点伤椎前缘高度及后凸Cobb角均较术前明显恢复（P＜0.01）。术后伤椎高度随随访时间延长逐渐下降，后凸Cobb角逐渐增大。取出内固定物后、术后2年、末次随访时动力位X线片上骨折椎体前后相对滑移距离分别为（1.9 ± 0.3）、（2.1 ± 0.2）、（2.1 ± 0.3）mm，两两比较差异无统计学意义（P＞0.05）。术后1、2年及末次随访时疼痛视觉模拟评分分别为（2.5 ± 1.2）、（2.5 ± 1.1）、（2.4 ± 1.3）分，两两比较差异无统计学意义（P＞0.05）。末次随访时Denis腰痛分级：P1级13例，P2级12例，P3级5例。功能障碍指数为（11.4 ± 3.1）分，获优23例、良5例、可2例。 结论 单纯微创椎弓根钉内固定技术治疗胸腰椎爆裂骨折中期临床效果满意，脊柱稳定性良好。Objective To mid-term efficacy of the technique of minimally invasive pedicle screw fixation on thoracolumbar burst fracture. Methods From September 2002 to September 2007, 30 patients were treated with minimally invasive pedicle screw fixation for thoracolumbar fracture. There were 16 males and 14 females with the mean age of 39.8 years (range,18-65 years). The injured level of was T11 in 3 cases, T12 in 13 cases, L1 in 12 cases, and L2 in 2 cases. The type of thoracolumbar fractures of all the patients was A3 according to AO classification. The during from injury to operation was 6 hours to 6 days with an average of 45 hours. The index of image and pain and disability index were evaluated after operation. Results All patients were followed up for 3 to 9 years with the mean of 5.2 years. Their average sliding distance after operation for removing internal fixation was (1.9 ± 0.3), and (2.1 ± 0.2) mm 2 years after the operation and (2.1 ± 0.3) mm at the latest follow-up. There was no significant difference (P＞0.05). Their average score was (2.51 ± 1.2) 1 year after the operation, was (2.42 ± 1.1) 2 year after the operation, and was (2.36 ± 1.3) at the latest follow-up (P＞0.05). According to Denis score system to evaluate index of lumbago, there was P1 in 13 cases, P2 in 12 cases, and P3 in 5 cases. The score of Oswestry Disability Index (ODI) was 11.4 ± 3.1 at the latest follow-up. Twenty-one cases gotexcellent therapeutic result, five cases got good and two were moderate. Conclusions Minimally invasive pedicle screw fixation for the treatment of thoracolumbar burst fracture provide satisfactory clinical results. The vertebral body and adjacent vertebral body have a good stability.
目的 评价微创椎弓根钉内固定技术治疗胸腰椎爆裂骨折的中期临床疗效。 方法 2002年9月－2007年9月，采用微创椎弓根钉内固定技术治疗胸腰椎爆裂骨折30例。其中男16例，女14例;年龄18～65岁，平均39.8岁。骨折节段:胸11者3例， 胸12者13例， 腰1者12例， 腰者22例。所有骨折按AO分型，均为A3型。受伤至手术时间6 h～6 d，平均45 h。分析术后影像学指标、疼痛评分及功能障碍指数。 结果 患者均获随访，随访时间3～9年，平均5.2年。术后各时间点伤椎前缘高度及后凸Cobb角均较术前明显恢复（P＜0.01）。术后伤椎高度随随访时间延长逐渐下降，后凸Cobb角逐渐增大。取出内固定物后、术后2年、末次随访时动力位X线片上骨折椎体前后相对滑移距离分别为（1.9 ± 0.3）、（2.1 ± 0.2）、（2.1 ± 0.3）mm，两两比较差异无统计学意义（P＞0.05）。术后1、2年及末次随访时疼痛视觉模拟评分分别为（2.5 ± 1.2）、（2.5 ± 1.1）、（2.4 ± 1.3）分，两两比较差异无统计学意义（P＞0.05）。末次随访时Denis腰痛分级：P1级13例，P2级12例，P3级5例。功能障碍指数为（11.4 ± 3.1）分，获优23例、良5例、可2例。 结论 单纯微创椎弓根钉内固定技术治疗胸腰椎爆裂骨折中期临床效果满意，脊柱稳定性良好。Objective To mid-term efficacy of the technique of minimally invasive pedicle screw fixation on thoracolumbar burst fracture. Methods From September 2002 to September 2007, 30 patients were treated with minimally invasive pedicle screw fixation for thoracolumbar fracture. There were 16 males and 14 females with the mean age of 39.8 years (range,18-65 years). The injured level of was T11 in 3 cases, T12 in 13 cases, L1 in 12 cases, and L2 in 2 cases. The type of thoracolumbar fractures of all the patients was A3 according to AO classification. The during from injury to operation was 6 hours to 6 days with an average of 45 hours. The index of image and pain and disability index were evaluated after operation. Results All patients were followed up for 3 to 9 years with the mean of 5.2 years. Their average sliding distance after operation for removing internal fixation was (1.9 ± 0.3), and (2.1 ± 0.2) mm 2 years after the operation and (2.1 ± 0.3) mm at the latest follow-up. There was no significant difference (P＞0.05). Their average score was (2.51 ± 1.2) 1 year after the operation, was (2.42 ± 1.1) 2 year after the operation, and was (2.36 ± 1.3) at the latest follow-up (P＞0.05). According to Denis score system to evaluate index of lumbago, there was P1 in 13 cases, P2 in 12 cases, and P3 in 5 cases. The score of Oswestry Disability Index (ODI) was 11.4 ± 3.1 at the latest follow-up. Twenty-one cases gotexcellent therapeutic result, five cases got good and two were moderate. Conclusions Minimally invasive pedicle screw fixation for the treatment of thoracolumbar burst fracture provide satisfactory clinical results. The vertebral body and adjacent vertebral body have a good stability.
【摘要】 目的 比较肠充盈超声检查法与常规经腹超声检查法在结直肠肿瘤中的诊断价值。 方法 对2008年6月-2009年6月64例经临床病理确诊的结直肠肿瘤患者分别经腹常规超声及肠充盈超声检查。在肠充盈状态下观察病变的形态，对病变进行定位并观察结直肠肿瘤的彩色多普勒血流信号。比较肠充盈超声检查法及常规经腹超声检查法在结直肠肿瘤的检出、定位和显示血流的能力的差异。 结果 常规经腹部超声检查发现32例结直肠肿瘤（32/64），病灶敏感性为50%； 肠充盈超声检查法发现病灶55例（55/64）， 病灶敏感性为85.9%。经腹常规超声检查的定位准确率为21.9%（7/32），肠充盈超声检查法对结直肠肿瘤的定位准确率为89.1%（49/55）。两种方法比较差异有统计学的意义（Plt;0.05）。 结论 肠充盈超声检查法在结直肠肿瘤的病变敏感性检出、定位准确性等方面优于经腹常规超声检查；而不同病理类型的结直肠肿瘤具有不同的超声声像图特征。【Abstract】 Objective To compare the diagnostic value between intraluminal contrast-enhanced hydrocolon ultrasonography and conventional transabdominal ultrasonography for of colorectal neoplasms. Methods The conventional transabdominal ultrasonography and hydrocolonic ultrasonography using an intraluminal contrast agent were performed on 62 patients from June 2008 to June 2009. The morphological features and location of the lesion were observed and the blood flow signals were observed. The different diagnostic value between conventional transabdominal ultrasonography and intraluminal contrast-enhanced hydrocolon ultrasonography was compared. Results The sensitivity of the intraluminal contrast-enhanced hydrocolon ultrasonography in the depiction of the colorectal neoplasms (55/64, 85.9%) was higher than that of the conventional transabdominal ultrasonography (32/64, 50%, Plt;0.05). And the accuracy of the intraluminal contrast-enhanced hydrocolon ultrasonography in locating the colorectal neoplasms (48/55, 87.3%) was higher than that of the conventional transabdominal ultrasonography (7/32, 53.2%, Plt;0.05). Conclusion Intraluminal contrast-enhanced hydrocolon ultrasonography is more valuable for colorectal neoplasms than conventional transabdominal ultrasonography in detecting and locating colorectal neoplasms. Colorectal neoplasms with different pathological types may have different ultrasonic features.
ObjectiveTo assess the effect of short-axis and long-axis punctures of thyroid nodules on the diagnostic rate of ultrasound guided aspiration biopsy (US-FNAB). MethodsWe retrospectively analyzed the clinical data of 2 686 thyroid nodule patients who underwent US-FNAB between March 2011 and November 2014. The US-FNAB was performed by 5 beginners (571 each for Dr1-Dr4 and 402 for Dr5). Yields of US-FNAB were divided into two levels according to the classification standard of the Bethesda system:adequacy and inadequacy. Short-axis puncture technique was used by Dr2 and long-axis puncture was performed by the others. According to chronological sequence of thyroid nodules examined, we compared the inadequate diagnostic rate between Dr2 and the others for the first 200 cases and the last 200 cases, respectively. The inadequate diagnostic rate was compared among the 4 doctors who used long-axis punctures for the first 200 cases and the last 200 cases, respectively. ResultsThe inadequacy rate of US-FNAB for Dr2 was higher than that for Dr1, Dr3, Dr4 and Dr5 in the first 200 cases, with statistical significance (P=0.036,<0.001,=0.007 and <0.001, respectively). There was no significant difference in inadequate diagnostic rate among the 4 doctors who used long-axis punctures for the first 200 cases (P=0.033, 0.551, 0.011, 0.122, 0.672 and 0.050). The inadequacy rate of US-FNAB for Dr2 was higher than that for Dr5 and lower than that for Dr4 in the last 200 cases with statistical significance (P=0.027 and 0.003, respectively). The inadequacy rate of US-FNAB for Dr5 was lower than that for Dr3 (P=0.005) and Dr4 (P<0.001) among the 4 doctors who used long-axis punctures for the last 200 cases. ConclusionFor beginners, the inadequacy rate of short-axis puncture is higher than long-axis puncture. We suggest beginners learn long-axis puncture method. There is no significant difference in inadequate diagnostic rate among short-axis and long-axis punctures, when the number of operated cases reaches 200. At this point, the operator can choose either way to puncture according to the disease condition or personal interests.