【摘要】 目的 探讨细菌性胶原酶对创口感染情况的影响。 方法 2006年11月-2006年12月，对28只新西兰兔分为实验组和对照组，分别予细菌性胶原酶溶液及生理盐水浸润创口并缝合。观察创口感染及局部皮肤的炎性细胞浸润情况。 结果 实验组与对照组创口感染率差别无统计学意（Pgt;0.05），炎性细胞差别无统计学意义（Pgt;0.05）。 结论 细菌性胶原酶在创伤修复过程中不能直接降低感染率，对炎性细胞的迁移并无明显的作用。 【Abstract】 Objective To assess the effects of bacterial collagenase on the wound infection. Methods A total of 28 New Zealand rabbits have chosen from November to December 2006, and were divided into a laboratorial group and a control group. We sutured the wounds and soaked them by the bacterial collagenase liquid or by the physiologic saline solution. The infection and the inflammatory cells of the skin around the wound were observed. Results The difference of the infection rates between the two groups was not statistically significant (P=0.62), nor the difference of inflammatory cells (P=0.84). Conclusions Bacterial collagenase can not decrease the rate of infection directly, and had no obvious effect on the transferring of inflammatory cells.
ObjectiveTo analyze the ultrasonic manifestations of myxoid liposarcoma (MLS) in soft tissues.MethodsWe retrospectively analyzed the ultrasonic characteristics of 10 cases of soft tissue MLS which were pathologically confirmed between January and June 2006. Results Ultrasonic manifestations: 8 cases occurred in muscles and 2 in subcutaneous tissues and muscles; the maximum mass diameter was (71.1±39.4) mm; 10 cases had clear border, 8 had regular shape, and 9 had posterior echo enhancement; 10 cases were all solid masses with mucous liquid zone (9 cases had mainly weak echo, among which 5 had strong echo areas; 1 case had mainly strong echo); bloodstream grade: 3 cases belonged to level 0, 3 level Ⅰ, 2 level Ⅱ, and 2 level Ⅲ. Pathologic findings: 2 cases had low differentiation; 1 case was a mixture of MLS and atypical lipoma with mainly strong ultrasonic echo; the rest 7 cases had middle or high differentiation.ConclusionsUltrasonic manifestations of soft tissue MLS are mostly large masses in the muscular layer with clear border, regular shape, posterior echo enhancement and mucous liquid zone. Various degrees of strong echo zone exist in the masses. Bloodstream and mucous liquid zone are correlated with differentiation degree, and ultrasonic manifestations can be influenced if other factors exist.
目的 探讨医院信息系统（HIS）在超声影像住院医生培养中的应用价值。 方法 对2003年－2009年在超声科参加住院医生培训的24名住院医生，应用HIS前后3年在临床、教学及科研方面的业绩进行对比。所选用的指标包括超声检查的请会诊次数、报告符合率、准备教学材料所花费的时间及质量、论文发表的数量。 结果 在HIS应用之前，24名超声科住院医生的请会诊次数为平均每周96次，平均每周4次/人，报告符合率为92%，准备教学材料花费的时间平均50 h，论文发表的数量共9篇，平均0.33篇/人，其中个案报道6篇，占67%，无科学引文索引收录论文。在HIS应用之后，24名超声科住院医生的请会诊次数为平均每周62次，平均每人每周2.58次/人，报告符合率为95%，准备教学材料花费的平均时间为36 h，论文发表的数量共15篇，平均0.63篇/人，其中包括3篇科学引文索引收录论文，个案报道9篇，占60%。 结论 超声影像是实践性很强的学科，HIS提供的素材和平台有利于超声科住院医生学习效率的提高。
【摘要】 目的 探讨肾上腺髓样脂肪瘤的彩色多普勒超声表现和超声诊断价值。 方法 回顾性分析2005年3月-2010年9月58例61个经手术及病理证实的肾上腺髓脂肪瘤病灶的彩色多普勒超声表现，对病变的大小、内部回声特点及血流特点进行分析。 结果 在2005年3月-2007年12月的28个病灶超声诊断出肾上腺病变23个，正确率82.1%；诊断为髓脂肪瘤2个，正确率7.1%；漏诊1个，误诊4个。2008年1月-2010年9月，33个病灶超声诊断出肾上腺病变30个，正确率90.9%；诊断为髓脂肪瘤19个，正确率57.6%；无漏诊，误诊3个。52个病灶超声表现为边界清晰，形态基本规则，内部呈均匀中等强回声（与肾集合系统回声相当），内部未测及血流信号， 另8个病灶表现为中等强回声与低回声相间。 结论 肾上腺髓样脂肪瘤具有特征性的彩色多普勒超声声像图表现， 可用于发现病变并对多数肾上腺髓样脂肪瘤做出定性诊断。【Abstract】 Objective To evaluate the value of sonographic diagnosis of adrenal myelolipoma. Methods Sonographic findings from 58 patients with pathologically proved adrenal myelolipoma from March 2005 to September 2010 were retrospectively analyzed. The size of the lesion, internal echo features, and characteristics of blood flow were observed and analyzed. Results In 28 patients with pathologically proved adrenal myelolipoma from March 2005 to December 2007, adrenal lesions was diagnosed in 23 with an accurate rate of 82.1%; adrenal myelolipoma was diagnosed in two with an accurate rate of 7.1%; missed diagnosed in one; misdiagnosed was in four. In 33 patients with pathologically proved adrenal myelolipoma from January 2008 to September 2010, adrenal lesions was diagnosed in 30 with an accurate rate of 90.9%; adrenal myelolipoma was diagnosed in 19 with an accurate rate of 57.6%; no missed diagnosed occurred; misdiagnosed was in three. The sonographic features in 52 lesions were smooth borders and homogeneous hyperechoic; no color Doppler flow signal inside was detected. Conclusion Adrenal myelolipoma has special sonographic features. Ultrasonography is a reliable imaging method for the diagnosis of adrenal myelolipoma.
ObjectiveTo analyze the results and diagnostic value of postoperative chylous test of pleural effusion and to verify the clinicopathological factors affecting the results of chylous test.MethodsThe clinical data of 265 consecutive patients undergoing selective surgery at the Department of Thoracic Surgery, Shangjin Nanfu Hospital between May and August 2020 were retrospectively analyzed, including 106 males and 159 females with an average age of 53.0±12.2 years. According to the results of the chylous test on the operation day and postoperative first and second days, the patients were divided into two subgroups, including a positive group and a negative group, and the clinical data of the two groups were compared. Sensitivity and specificity of the chylous test were calculated. The influencing factors for chylous test were analyzed by multiple logistic regression analysis.ResultsThe positive rate of chylous test was 91.7%, 95.8% and 87.9% on the operation day and postoperative first and second days, respectively. There was no statistical difference in age, sex, surgical type, surgical approach, surgical site, surgical time, degree of lymph node dissection, treatment of thoracic duct, 24 hours pleural fluid drainage or 24 hours protein and fat food intake between the positive group and the negative group (P>0.05). The diagnostic sensitivity and specificity of the chylous experiment were 100.0% and 4.0%, respectively. Multiple logistic regression analysis showed that the surgical site (left/right chest) might be an influencing factor for the results of the chylous test (P=0.043, OR=0.458, 95%CI 0.216-0.974).ConclusionThe positive rate of chylous test of pleural effusion after thoracic surgery is very high. The chylous test produces a high misdiagnosis rate of chylothorax. The surgical site (left/right chest) may be an influencing factor for chylous test. The positive result of chylous test is not recommended as the direct diagnostic basis for postoperative chylothorax and guidance of the subsequent treatment.