简介：［摘要］目的探讨小肾癌的CT影像特点。方法12例经病理证实的小肾癌，分别行螺旋CT平扫和皮质期、实质期及肾盂期增强扫描，分析其影像特征。结果12例癌灶中，平扫8例等密度、3例低密度、1例稍高密度，其中2例伴斑点样钙化；增强扫描皮质期6例癌灶与肾皮质增强程度相近，6例癌灶皮质期增强程度低于肾皮质；实质期、肾盂期癌灶增强程度下降，肾盂期癌灶境界显示清晰。结论小肾癌的螺旋CT表现有一定特征性，尤其是“快进快退”现象，可为确定性诊断提供依据。

简介：目的：探讨腮腺腺淋巴瘤的MR表现特征。方法：回顾性分析12例经病理证实的腺淋巴瘤患者MR及临床资料,男性10例,女性2例,平均年龄59.1岁。观察病灶的数目、部位、形态、边界、大小以及MR信号特点等。结果：12例中,单发9例,多发3例,共17个病灶。其中12个病灶位于腮腺浅叶后下部,13个病灶为纵向生长椭圆形。T1WI上16个病灶为等或稍高于肌肉信号,1个含有高信号。STIR序列中等稍高信号者7个,10个含有大小不等的明显高信号。增强扫描轻到中度强化者15个,明显强化2个。9个病例颈部可见中等大小淋巴结。结论：50岁以上吸烟男性,发现腮腺浅叶后下方边界清楚、纵向生长椭圆占位,STIR序列信号欠均匀,高度提示腺淋巴瘤。

简介：摘要目的探讨动态脑电图在癫痫诊断和鉴别诊断中的应用价值。方法回顾性分析我院2013年6月至2015年6月收治的80例癫痫患者的临床资料，对照研究56例癫痫和24例可疑癫痫患者常规心电图和动态心电图检测结果。结果癫痫组常规脑电图检测痫总异常率为37.5%（21/56），动态心电图检测总异常率为76.8%（43/56），比较差异显著（P＜0.05）；可疑组常规脑电图检测总异常率为20.8%（5/24），动态心电图检测总异常率为45.8%（11/24），比较差异显著（P＜0.05）。结论与常规心电图检测相比，动态脑电图在癫痫诊断和鉴别诊断中准确性更高，具有较高的临床应用价值。

简介：摘要：目的：探讨甲状腺疾病病理诊断与鉴别诊断的价值。方法：选择我院 2019年 1月至 2019年 12月收治的 50例甲状腺疾病患者，采取石蜡病理诊断的方式。结果：女性 41例 (82.00%)，男性 9例 (18.00%)。男女患者间差异有统计学意义 (P<0.05)。结节性甲状腺肿 37例，占 74.00%。 7例甲状腺乳头状癌，占 14.00；甲状腺滤泡癌 6例，占 12.00%，良恶性患者间差异有统计学意义 (P<0.05)。结论：对我院甲状腺疾病患者进行分析后发现，女性患者总数明显高于男性患者，结节性甲状腺肿患者最多，以良性为主。

简介：摘要目的探讨肾上腺结核CT诊断及鉴别诊断价值。方法2012年6月至2015年6月，我院收诊肾上腺结核患者18例，对患者的基本资料进行回顾性分析，同时对CT检查结果进行分析，以判定肾上腺结核CT诊断及鉴别诊断的价值。结果18例患者中，双侧发病患者人数居多，其中单侧4例、双侧14例。就肾上腺形态观察而言，包括肾上腺检测体积增大者9例，体积缩小者2例，肾上腺失去正常形态者共7例。而经病理学提示，本次18例患者中误诊2例，所占比例为11.1%。结论对肾上腺结核患者进行CT诊断，主要可见双侧发病、钙化等基本特征，而通过上述特征可助于医师判断患者的疾病严重程度，与其他肾上腺疾病进行鉴别，为疾病治疗提供重要信息。

简介：摘要目的讨论在早期肝硬化的临床诊断中彩色多普勒超声的参考价值。方法选取我院2016年3月至2017年3月在我院使用彩色多普勒超声进行肝功能检查的患者20例与进行常规体检的健康者15例，分析超声所反映的门静脉系统血流动力学变化。对比早期肝硬化患者与健康人血流动力学差异。结果早期肝硬化患者门静脉比健康人略粗，血流速度较健康人慢。二者门静脉内径有明显差异。结论利用彩色多普勒超声有助于早期肝硬化患者的确诊。

简介：摘要目的研究乳腺超声诊断乳腺疾病的临床价值。方法选取50位我院在2015年8月至2016年12月期间收治的乳腺疾病病患，均经过CT诊断或B超诊断确诊为乳腺病症。以病理学诊断为金标准，判断乳腺超声诊断下准确率。结果超声诊断下准确率为86%，其中乳腺癌占比8%、纤维腺瘤占比6%、乳腺炎占比20%、乳腺增生占比52%。超声分级标准下，5级占比6%、4级占比6%、3级占比26%、0级占比48%。结论超声方式诊断乳腺疾病可清晰显示患者乳腺内部结构状态，诊断准确性较高，可作为初期及辅助诊断操作。

简介：摘要：儿科急腹症临床发病率高、病因复杂多样、病情进展迅速，及时诊断病情对临床医生根据患儿实际情况制定针对性治疗方案具有积极意义，也是保障其疗效及预后的关键。近年来有研究认为，将超声应用于儿科急腹症辅助诊断工作中或可获得较优效果。本研究探讨超声应用于诊断儿科急腹症患儿的临床价值。

简介：摘要 目的：探讨癌胚抗原（CEA）、细胞角蛋白21-1（CYFRA21-1）、糖类抗原12-5（CA12-5）与神经元特异性烯醇化酶（NSE）四种血清肿瘤标志物联合检测对于肺癌诊断的临床应用性价值。方法：随机选取临沂市沂水中心医院2022年9月至2023年2月就诊的肺病患者为研究对象，60例肺癌患者为研究组，60例肺良性病变患者为良性病变组。选取同期在本院体检的60例肺部健康的体检者为对照组。对三组研究对象进行癌胚抗原（CEA）、细胞角蛋白21-1（CYFRA21-1）、糖类抗原12-5（CA12-5）与神经元特异性烯醇化酶（NSE）检测，对检测结果进行对比分析。结果：研究结果显示，研究组的CEA、CYFRA21-1、CA12-5、NSE表达水平高于对照组和良性病变组（P＜0.05），差异具有统计学意义。四项联合检测的灵敏度、特异性、准确性均高于单项检测，存在显著差异，具有统计学意义（P＜0.05）。结论：癌胚抗原、细胞角蛋白21-1、糖类抗原12-5与神经元特异性烯醇化酶四种血清肿瘤标志物联合检测的特异性、灵敏度、准确度均高于单项检测，可以为早期肺癌的诊断提供一定的参考依据。

简介：摘要目的探讨血清维生素B12作为无创指标预测肝硬化伴食管胃静脉曲张患者远期再出血预后的价值。方法纳入2016年12月1日至2017年12月31日因肝硬化食管胃静脉曲张出血至复旦大学附属中山医院接受内镜治疗预防再出血并行血清维生素B12、叶酸检测的患者。对患者内镜之后3年再出血进行ROC曲线、Kaplan-Meier生存分析、单因素及多因素Cox回归分析，探讨不同维生素B12水平预测3年静脉曲张再出血的价值。结果共纳入115例患者，ROC曲线分析提示血清维生素B12预测3年再出血的最佳截断值为567.25 pg/ml。根据截断值将患者分为高维生素B12水平组(n＝49)和低维生素B12水平组(n＝66)。与维生素B12低水平组比较，维生素B12高水平组患者白蛋白水平偏低，男性比例更少(63.3% vs 80.3%)，3年再出血率更高(P<0.05)。Cox分析提示维生素B12及血小板是静脉曲张出血患者3年再出血的独立预后因素。结论外周血维生素B12升高预示肝硬化食管胃静脉曲张患者更高的远期再出血风险。

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简介：摘要目的探讨血清维生素B12作为无创指标预测肝硬化伴食管胃静脉曲张患者远期再出血预后的价值。方法纳入2016年12月1日至2017年12月31日因肝硬化食管胃静脉曲张出血至复旦大学附属中山医院接受内镜治疗预防再出血并行血清维生素B12、叶酸检测的患者。对患者内镜之后3年再出血进行ROC曲线、Kaplan-Meier生存分析、单因素及多因素Cox回归分析，探讨不同维生素B12水平预测3年静脉曲张再出血的价值。结果共纳入115例患者，ROC曲线分析提示血清维生素B12预测3年再出血的最佳截断值为567.25 pg/ml。根据截断值将患者分为高维生素B12水平组(n＝49)和低维生素B12水平组(n＝66)。与维生素B12低水平组比较，维生素B12高水平组患者白蛋白水平偏低，男性比例更少(63.3% vs 80.3%)，3年再出血率更高(P<0.05)。Cox分析提示维生素B12及血小板是静脉曲张出血患者3年再出血的独立预后因素。结论外周血维生素B12升高预示肝硬化食管胃静脉曲张患者更高的远期再出血风险。

简介：AbstractCOVID-19 has become a pandemic and it has already spread to at least 171 countries/regions. Chronic kidney disease (CKD) is a global public health problem with a total of approximately 850 million patients with CKD worldwide and 119.5 million in China. Severe COVID-19 infection may damage the kidney and cause acute tubular necrosis, leading to proteinuria, hematuria and elevated serum creatinine. Since the SARS-CoV-2 enters the cells by binding to the angiotensin-converting enzyme 2 receptor, some doctors question its ability to increase the risk and severity of developing COVID-19. Neither clinical data nor basic scientific evidence supports this assumption. Therefore, patients who take angiotensin-converting enzyme inhibitor or angiotensin receptor blocker are not advised to change their therapy. Patients with CKD are generally the elderly population suffering from multiple comorbidities. Moreover, some patients with CKD might need to take glucocorticoids and immunosuppressants. Dialysis patients are recurrently exposed to a possible contaminated environment because their routine treatment usually requires three dialysis sessions per week. Considering all the above reasons, patients with CKD are more vulnerable to COVID-19 than the general population. The development of COVID-19 may worsen the impaired kidney function and further lead to rapid deterioration of kidney function and even death. Strict comprehensive protocols should be followed to prevent the spread of COVID-19 among patients with CKD. In this review, we provide some practical management recommendations for health care providers, patients with CKD, dialysis patients and dialysis facilities.

简介：AbstractRespiratory health in the general population declines regardless of the presence of pulmonary diseases. Oxidative stress has been implicated as one of the mechanisms involved in respiratory dysfunction. This review was to evaluate studies that relate oxidative stress factors with pulmonary function among the general population without prior respiratory illnesses. The search yielded 54 citations. Twenty-one studies qualified for incorporation in this review. Owing to the heterogeneity of the review, studies were discussed based on identified oxidative stress factors responsible for pulmonary dysfunction. Oxidative stress biomarkers, including gene polymorphisms of nuclear factor erythroid 2-related factor 2, heme oxygenase 1, glutathione S transferase, superoxide dismutase, and lipid peroxidation products were involved in lung function decline. In addition, the antioxidant status of individuals in reference to dietary antioxidant intake and exposure to environmental pollutants affected oxidative stress and pulmonary function, as indicated by forced expired volume in one second, forced vital capacity, and forced expiratory flow at 25%-75%. This review indicated that oxidative stress is implicated in the gradual decline of lung function among the general population, and gene polymorphism along the antioxidant defense line and/or their interaction with air pollutants reduce lung function. Different polymorphic forms among individuals explain why the rate of lung function decline differs among people. Dietary antioxidants have respiratory health benefits in antioxidant gene polymorphic forms. Therefore, the genetic composition of an individual may be considered for monitoring and identifying people at risk of respiratory illnesses.

简介：ObjectivesTostudythecharacteristicofpulmonaryembolism(PE)incontrast-enhancedCT.MethodsTheradiologicalfeaturesweredescribedin20patientswithlobarandproximalPEdiagnosedwithaToshibaXpress/SXCTscanneraftercontrastmaterialwasadministrated.ResultsTherewere7casesofpulmonaryembolism(PE)secondarytolowerlimbdeepveinthrombosis(DVT),ofwhich2caseswererelatedtosaunabath.Wegroupedthecasesaccordingtotheirextensivenessofembolism:mild,moderate,severe,orcompleteembolism.Mildembolism:theembolioccupiedlessthan30%,oftheinnerdiameterofpulmonaryartery(PA).Medianembolism:theembolioccupied30~50%ofthePAdiameter.Severeembolism:theembolioccupiedoverhalfofthePA(50%),buttherewerecontrastflow.Completedembolism:therewasnocontrastfoundaroundtheemboli.ThedirectsignofPEwasafillingdefectornoopacificationintheaffectedbranchofpulmonaryartery(PA).Therewere9othersecondarysigns:①widenPA,②enlargedrightventricleandtherightatrium,③increasedtranslucencyofthelunganddecreasedbronchovascularshadows,④shrunkenpulmonaryveinslikeddriedrattan,⑤decreasedleftatriumandtheleftventriclesize,⑥shiftingofinterventricularseptumtotheleftandposteriordirection,⑦Thelaterallungparenchymademonstratedinatriangularshape,⑧pleuraleffusionand⑨pericardiacleeffusion.ConclusionsThediagnosisofPEwasrevealedby10radiologicalsignsbycontrast-enhancedCT:Withfullunderstandingofthepathophysiologicalbasisofthese10signs:correctdiagnosisofpulmonaryembolismcanbemade.PEiscommonlycausedbylowerlimb.Andsaunabathisoneofthemainpredisposingcauses.

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简介：ObjectivesWedidaretrospectivestudytosummarizethesurgicalexperienceofanomalouspulmonaryvenousdrainage(APVD)correctionanddiscusseffectivewayofimprovingthesurgicaloutcome.MethodsFromJanuary1985toMay2008,127patients[56menand71women,aged14-55yearswithanaverageof(26.79±10.62)years]withAPVDunderwentsurgicaltreatments.Amongthem,13patientshadsimplepartialAPVDwithintactatrialseptum,104patientshadpartialAPVDwithatrialseptaldefectand10patientshadtotalAPVD.Seventy-onepatientsofthemaccompaniedwithothercardiacanomalieswhichwerealsocorrectedintheiroperations.ResultsOneearlyoperativedeathduetoseverelowcardiacoutputsyndrome(LCOS)developedpostoperatively,whichresultedinamortalityrateof0.78%.Amongotherpatients,10patientscomplicatedwithLCOS,11patientswitharrhythmia,7patientswithacuterenalfailureand4patientswithpoorwoundhealing,alldischargedfromhospitalaftertreatment.Postoperativeechocardiographyreexaminationrevealed1caseofmildresidualshuntinatrialseptumbutwithoutpulmonaryveinstenosis.ConclusionForrightatrialandventricleenlargedpatientswithorwithoutpulmonaryhypertension,surgeonsshouldbevigilanceofaccompaniedAPVDwhetheratrialseptaldefectsexistornot.Aslongasnocontraindicationsarefound,surgicaltreatmentshouldbeperformedonceaccuratediagnosisisobtained.

简介：ThepulmonarymicrocirculationoftheFontananimalmodelestablishedbytwodifferentprocedures,wasobservedbyusinglaserDopplerthermometer.Tenmongrelcaninesweredividedintotwogroupswith5ineachaccordingtodifferentsurgicalprocedures.ThemicrocirculationflowofthemiddleupperlobeofthepulmonarywasmeasuredbeforeandafterFontancirculationwasestablishedwhiletheleftsignofthecaninewasinstablecondition.Frictioninspirednooxygen

简介：Severalcomplicationsofinsertionanduseofpulmonaryarterycatheter(PAC),includingcatheterentrapment,arerecognizedduringoraftercardiacsurgery.Earlydetectionisveryimportant.WereportacaseofPACentrapmentbecausethethecatheterwasaccidentallysuturedtothesuperiorvenacava.Bleedingfromthethermistorconnectorwasinitiallydetectedaftersurgerybecausetheneedlepuncturedthelumenofthermistorconnector.ThePACwasremovedthroughre-exploration.Therefore,bleedingfromthethermistorconnectorcouldearlyindicatethePACentrapment.Wesuggestthatabnormalbleedingfromthenon-injectatelumenportsofPACshouldbecheckedbeforesternalclosure.

简介：Heartratevariaty(HRV)of85caseswithAMIwasobservedintheearlyphaseafteronsetandrehabilitationphaseatfirstmonthandsixthmonth,andwascontrastedwithsixtimethresholdindicesof111caseswithcoronaryheartdiseaseandthatof35normalcontrol.WefoundtheHRVofAMIwasapperantlylowerintheacutephasethanthatofcoronaryheartdiseaseandnormalcontrols.HRVrecoveredgraduallywithincliningtobestableafterhalfayear,butitwasstilllowerthanthatofcontrols.LowHRVinearlyphaseofAMIsuggestedthepoorprognosis.