高血压病的复俣超声心动图研究

现常用于检测高血压病的彩色、脉冲多普勒及二维、Ｍ型超声心动图几种方法,各有其优点与不足。本文利用其各自的优点,运用上述复合超声心动图法检测９６例高血压病患者及９６例正常人,进行了分析研究,认为,此法检诊高血压病是实用、可行的。     

糖尿病的复合超声心动图研究

现用于检测非胰岛素依赖性糖尿素（ＮＩＤＤＭ）的彩色,脉冲多普勒及二维,Ｍ型超声心动图几种方法,各有优点与不足,本文利用其各自的优点,运用复合超声心动图法检测３０例无高血压的ＮＩＤＤＭ及３２例正常人,进行了对比。发现病变组心脏的收缩,舒张功能均有下降,认为,用此方法检测早期ＮＩＤＤＭ心脏改变是实用,可行的。     

对比增强经颅多谱勒超声对心房右向左分流患者的诊断价值的分析

目的:比较对比增强经颅多普勒超声与经胸壁超声心动图、经食管超声心动图对心房右→左分流患者的鉴别诊断价值。方法:回顾性分析2014年9月至2018年11月哈尔滨医科大学附属第一医院经手术证实的41例心房右→左分流患者对比增强经颅多普勒超声及经胸壁超声心动图的检查所见及诊断结果,并回顾性分析其中29例患者对比增强经颅多普勒超声、经胸壁超声心动图及经食管超声心动图的检查所见及诊断结果。结果:在经手术证实的41例心房右→左分流患者中,对比增强经颅多普勒超声检查阳性结果 41例,阴性结果 0例,诊断准确性为100%;经胸壁超声心动图检查阳性结果 20例,阴性结果 21例,诊断准确性为48.8%。其中,同时进行对比增强经颅多普勒超声、经胸壁超声心动图及经食管超声心动图检查的29例患者中,经胸壁超声心动图阳性结果 12例,阴性结果 17例,诊断准确性为41.4%;经食管超声心动图检查阳性结果 24例,阴性结果 5例,诊断准确性为82.8%。结论:对比增强经颅多普勒超声可提高心房右→左分流的诊断准确率,其与经胸壁超声心动图及经食管超声心动图结合应用可提高心房右→左分流的鉴别诊断能力。     

超声心动图检测胎儿心包积液的临床价值

目的:探讨超声心动图检测胎儿心包积液的临床意义。方法:2007-2010年在我院检查行超声心动图检查的高危孕妇473例,同时设对照组,检测孕龄在20-40周无明显高危妊娠因素的孕妇472例,并将产前超声检查结果和胎儿尸检或分娩后超声心动图检查结果进行对照。结果:1.高危组检出72例心包积液,检出率12.5%,对照组检出13例心包积液,检出率3%,两组胎儿心包积液检出率间差别有统计学意义(x2=39.57,P<0.05)。2.85例心包积液中,孤立性心包积液38例,伴其他心脏畸形或者其他系统畸形47例,其中孤立性心包积液预后良好。结论:超声心动图能够敏感地检出胎儿心包积液;心包积液程度并不是最重要的,其伴随心脏畸形或者其他畸形决定预后。     

超声心动图检测胎儿心包积液的临床价值

目的：探讨超声心动图检测胎儿心包积液的临床意义。方法：2007-2010年在我院检查行超声心动图检查的高危孕妇473例,同时设对照组,检测孕龄在20-40周无明显高危妊娠因素的孕妇472例,并将产前超声检查结果和胎儿尸检或分娩后超声心动图检查结果进行对照。结果：1.高危组检出72例心包积液,检出率12.5%,对照组检出13例心包积液,检出率3%,两组胎儿心包积液检出率间差别有统计学意义（x2=39.57,P〈0.05）。2.85例心包积液中,孤立性心包积液38例,伴其他心脏畸形或者其他系统畸形47例,其中孤立性心包积液预后良好。结论：超声心动图能够敏感地检出胎儿心包积液;心包积液程度并不是最重要的,其伴随心脏畸形或者其他畸形决定预后。     

超声心动图评价左房形态和功能的临床应用进展

左房形态和功能既可反映机体的生理状态,也可反映其病理状态,左房形态和功能异常改变是冠心病、高血压、心血管硬化、中风等诸多心血管疾病的早期表现之一,是心血管死亡、心肌梗死、卒中、心力衰竭等不良心血管事件的危险因素之一,与这类疾病的预后密切相关,因而准确、有效评估左房形态和功能在不良心血管事件的诊疗及预后评估中意义重大。采用超声心动图评价左房形态和功能具有无创、实时高效、价格低廉及可重复性高等优点,临床上应用非常广泛。随着超声技术的进步,除二维超声心动图、彩色多普勒超声心动图等常规超声技术外,组织多普勒显像(TDI)技术、由TDI派生出来的应变及应率显像技术、实时三维超声心动图(RT-3DE)、二维斑点追踪成像(2D-STI)技术、三维斑点追踪成像(3D-STI)技术等新型超声技术也逐渐应用于左房形态、功能的评价中,然而不同的超声技术评价左房形态和功能仍有一定的不足之处,本研究就不同超声心动图评价左房形态和功能的临床应用及研究进展进行综述。     

国产Amplatzer蘑菇伞介入治疗中老年动脉导管未闭的近中期疗效分析

目的：评价国产Amplatzer蘑菇伞介入治疗中老年动脉导管未闭（patentductusarteriosus,PDA）的近中期临床疗效及安全性。方法：选择2007年1月至2011年12月我院收治的32例中老年PDA患者,经临床、心电图、x线及经胸超声心动图（TTE）检查确诊,均成功行介入治疗。术后行心电图、x线胸片、TTE随访。结果：32例均1次封堵成功,成功率100％。无重要并发症发生。随访x线胸片显示肺血较术前减少,心胸比率不同程度缩小。术后48小时（32例）超声心动图显示左房内径（LAD）、左室舒张末内径（LVDd）及肺动脉收缩压（PASP）较封堵前明显缩小（P〈0．01）;术后1、3、6月（32例）超声心动图随访显示LAD及LVDd、PASP进一步缩小;术后1年（30例）、术后2年（20例）、术后3年（12例）、术后4年（5例）超声心动图随访显示心脏大小及肺动脉收缩压恢复正常。结论：国产Amplatzer蘑菇伞介入治疗中老年PDA具有操作简单、创伤小、安全且技术成功率高、住院时间短等优点,近中期疗效明确,并发症少。     

超声心动图联合心电图对妊娠中期心脏畸形胎儿的诊断价值

摘要 目的：探讨超声心动图联合心电图对妊娠中期心脏畸形胎儿的诊断价值。方法：回顾性分析我院2019年1月到2021年1月出生后确诊与尸检确诊为心脏畸形的80例胎儿的临床相关指标,分析80例胎儿超声心动图检查与胎儿心电图检查结果,并分析超声心动图联合心电图对妊娠中期心脏畸形胎儿的诊断价值。结果：80例胎儿有56例出现不同程度的心电图异常现象,其中胎心早搏3例、FQRS振幅增高12例、ST段改变15例、FQRS时限增宽3例、胎心不齐4例、胎心过缓3例、胎心过速16例;80例胎儿通过尸检和出生后随访最终确定左心发育不良综合征（HLHS）4例,单心室6例,完全性心内膜垫缺损（ECD）8例,法洛四联症（TOF）14例,卵圆孔直径大于 6 mm 17例,室间隔缺损（VSD）31例,与超声心动图诊断结果对比无显著差异（P＞0.05）,超声心动图有7例漏诊;联合诊断与超声心动图和心电图对左心发育不良综合征、单心室、完全性心内膜垫缺损胎儿的诊断对比无明显差异（P＞0.05）,对法洛四联症、卵圆孔直径大于 6 mm、室间隔缺损和心脏畸形诊断总数方面联合诊断优于超声心动图和心电图单一诊断（P＜0.05）;通过不同检查的检测价值对比发现,超声心动图联合心电图检查的准确度、敏感度、特异度、阳性预测值和阴性预测值明显高于超声心动图与心电图单一检查。结论：超声心动图和心电图对于妊娠中期心脏畸形胎儿的诊断均具有重要价值。心脏畸形胎儿在妊娠中期进行心电图检查会出现异常现象,但是并不能确诊为心脏畸形,还需后续继续应用超声心动图进行检查,最终确诊胎儿是否存在心脏畸形现象。     

脉冲多普勒对高血压病左室舒张功能的监测

本文选自我院92年11月～94年1月期间的高血压门诊中原发性高血压患者126例和正常人群中无心脏器质性病变20例,作为两组比较。运用心脏超声及超声脉冲多普勒检测两组人群的心脏二尖瓣血流速及流速时间积分。用以观察高血压病左室舒张功能的受损状况及评价高血压严重程度对左室舒张功能的影响。结果表明,脉冲多普勒可作为一种监测高血压病左室舒张功能有效手段。且左室舒张功能受损状况与高血压病严重程度呈密切的相关关系。     

超声心动图对缺血性二尖瓣反流血流动力学的研究

目的:应用超声心动图研究缺血性二尖瓣反流(IMR)所致左室、二尖瓣环动力学变化。方法:超声心动图检测86例缺血性二尖瓣反流患者(前壁心肌梗死49例,下壁心肌梗死37例)和30例正常人的心脏,测量左室参数及二尖瓣环形态参数。结果:IMR组左室EDV、ESV增加,LVEF减低,但与对照组无显著差异;二尖瓣环面积及位移与对照组有显著差异;不同部位心肌梗死均发生明显左室重构;下壁梗死组PPM-AMP明显延长。结论:超声心动图作为心肌梗死患者的常规检查,可以针对不同患者进行不同的参数检查,这也为临床医生选择个性化治疗方案和疗效评价提供了依据。     

两种不同方法对阴道感染的评价

目的探讨需氧菌阴道炎／细菌性阴道病五项联合测定试剂对阴道感染的临床应用价值。方法将380例就诊女性采用需氧菌阴道炎／细菌性阴道病五项联合测定试剂方法,同时采刖自带常规镜检＋PH值方法进行检测。结果380例阴道分泌物标本经五项联合测定试剂方法检出阴道微生态失衡345例（其中包括AV、BV、CV、VVT等感染）,阳性率为90．79％;采用白带常规镜检＋pH值方法检出阴道微生态失衡328例（其中包括AV、BV、CV、VVT等感染）,阳性率为86．32％,两种检查方法结果差异明显。结论需氧菌阴道炎／细菌性阴道病五项联合测定试剂法准确,快速,高效,能及时评价阴道微生态状况,提高临床合理用药程度,值得临床推广应用。     

Chemiluminescent detection of AFLP markers

Nonradioactive amplified fragment-length polymorphism (AFLP) marker detection, a PCR-based, DNA-fingerprinting technique, was achieved by blotting AFLP products after electrophoresis onto a nylon membrane and subsequently hybridizing the blot with an alkaline phosphatase-labeled AFLP probe. Similar AFLP profiles were obtained by both a nonradioactive, chemiluminescent detection technique and by conventional AFLP marker detection using 32P-labeled AFLP primers. The suitability of the method using different gel systems combined with subsequent chemiluminescent detection of AFLP markers is validated by similar dendrograms that were generated using the unweighted pair group method with arithmetic averages (UPGMA). Moreover, chemiluminescent detection of AFLP markers using a universal AFLP nonradioactive probe has been successfully applied on prokaryotes such as Agrobacterium and eukaryotic genomes such as soybean and fungi.     

890例疑似细菌性阴道病患者阴道分泌物检测结果与分析

目的探讨BV三项检测法在阴道感染诊断中的价值。方法对890例阴道分泌物进行常规检查和BV三项检测。结果 890例疑似细菌性阴道病患者中,BV三项检测法检出BV患者772例(占总数的86.74%),常规镜检(Am sel标准法)检出BV患者763例(占总数的85.73%),二者的符合率为93.40%,具有中度一致性(Kappa=0.746,P0.05)。890例疑似细菌性阴道病患者中,BV合并VVC感染患者129例(占总数的14.49%),BV合并TV感染患者41例(占总数的4.61%),混合感染(BV+VVC、BV+TV)的发病率达到了19.10%(170/890)。结论 BV三项检测法不仅可初筛混合感染,而且与Am sel标准法在诊断BV方面具有较高的一致性,该检测方法快速准确,适宜临床推广与应用。     

Species-Specific Detection of Vibrio anguillarum in Marine Aquaculture Environments by Selective Culture and DNA Hybridization

Methods for specific detection of Vibrio anguillarum in complex microbial communities within diverse marine aquaculture environments were evaluated. A system for the detection of culturable cells based on the combined use of a selective medium and a nonradioactively labeled oligodeoxynucleotide complementary to 16S rRNA was developed. Four hundred fourteen bacterial cultures were evaluated in order to assess the specificity of the method. When both the selective medium and the specific probe gave positive results, the cultures were always identified as V. anguillarum. The selectivity for colony hybridization was 1 V. anguillarum cell in 10,000 total bacterial cells in environmental samples. The utility of the method was also compared with detection by dot blot hybridization of either raw DNA purified from environmental samples or PCR-amplified DNA of 16S rRNA genes, using universal eubacterial primers. The post-PCR hybridization was more sensitive (8 x 10(sup2) cells) than direct hybridization of the whole purified DNA (10(sup6) cells). However, the selective medium-probe combined method was as sensitive as post-PCR hybridization, albeit more specific.     

A fluorescence polarization assay using oligonucleotide probes for the rapid detection of verotoxin-producing Escherichia coli

A hybridization assay using fluorescence polarization was combined with the asymmetric polymerase chain reaction (PCR) in a method for the detection of the verotoxin type 2 gene of verotoxin-producing Escherichia coli. Six oligonucleotide probes labeled with FITC were designed and evaluated. One of these gave a detection limit of 10(3) colony forming units per assay, and assay results could be obtained within 5 min after PCR. It appears that the detection limit was restricted mainly by the extent and fidelity of PCR amplification, rather than by the sensitivity of the fluorescence polarization technique, indicating that good probe design facilitates the rapid detection of the PCR product. The fluorescence polarization assay, in conjunction with DNA amplification by PCR, is a powerful and widely applicable method for the rapid and sensitive detection of oligonucleotide sequences.     

High-throughput comprehensive analysis of D- and L-amino acids using ultra-high performance liquid chromatography with a circular dichroism (CD) detector and its application to food samples

A rapid and comprehensive analytical method for D- and L-enantiomers of proteinogenic amino acids was developed using ultra-high performance liquid chromatography (UHPLC) equipped with a circular dichroism (CD) detector. Pre-column derivatization reagents were examined for enhanced sensitivity and selectivity for UV and CD detection: 4-fluoro-7-nitro-2,1,3-benzoxadiazole (NBD-F) was selected. The method, using a CD detector, does not require separation of optical isomers on a column to calculate the enantio ratio (%D) using the g-factor value and produces a simple chromatogram in comparison to other reported methods. Using this advantage, combined with UHPLC technology, analysis time for the derivatized proteinogenic amino acids was within 5.5 min. The UV detection limit was 4.9-23 pmol/injection and the CD detection limit was 11-64 pmol/injection. The method was applied to the analysis of D- and L-amino acids in food samples. D-Ala, D-Asp, D-Glu and D-Ser were detected at high concentrations in some Japanese black vinegars, fermented milks and yogurts. The results were identical to the results determined by the OPA method. We suggest the UHPLC-CD method would be useful in screening the D-amino acid content of foods and in helping to clarify the importance and reason for the presence of D-amino acids in foods.     

F0F1-ATPase分子马达技术对单核细胞增生李斯特菌检测的研究

利用载色体chromatophore上的F₀F₁-ATPase分子马达生物传感器,建立了应用在食品检测中快速检测方法。首先从嗜热菌中提取载色体后,标记荧光探针F-DHPE,合成生物素化单增李氏菌prfA探针,在已标记F-DHPE的载色体ATP合酶的ε亚基上连接ε亚基抗体-生物素-链霉亲和素-生物素-prfA探针,将待测单核细胞增生李斯特菌标准菌株和阴性对照分别与此生物传感器结合,通过环境H+量测定ATP产生量,进而对单核细胞增生李斯特菌DNA进行检测。结果表明,chro prfA(连接在载色体chro上的prfA探针)的浓度在0.052 mg/mL,单核细胞增生李斯特菌DNA浓度在40 ng/mL为最适检测条件。通过传统检测方法及PCR检测方法对照,本方法具有良好的检测符合性。     

Sensitive determination method of estradiol in plasma using high-performance liquid chromatography with electrochemical detection

The improvement in the sensitive determination method of estradiol using HPLC with electrochemical detection is described. The improvement was due to the optimization of the potential applied to the electrode of the analytical cell and employment of a guard cell. The detection conditions were optimized from the electrochemical properties of estradiol in acidic and alkaline eluents. The employment of the guard cell drastically decreased the background noise without any reduction in the response of estradiol, and contributed to improvement in the sensitivity. The optimized method combined with pretreatment by liquid-liquid extraction was applied to the determination of estradiol in rat plasma. The detection limit of 8 pg for the standard solution and 24 pg for the plasma sample, which was about 6-8-fold more sensitive compared to the previous reports, was attained.     

选择性入肝血流阻断应用于肝癌合并门脉高压手术中的疗效观察

目的：探究选择性入肝血流阻断（SPVE 法）在肝癌合并门脉高压手术中的临床应用效果。方法：选择我院2009 年10 月 ~2014 年10 月期间确诊为肝癌合并门脉高压的患者80 例,按照随机数字数表法分为观察组和对照组各40 例,观察组行SPVE 法进行血流阻断,对照组行全入肝血流阻断法（Pringle 法）进行血流阻断。对比两组手术时间、阻断血流时间、手术中出血量、输血 量、手术前后患者肝功能相关指标及术后并发症发生率。结果：两组手术时间和血流阻断时间对比差异无统计学意义（P>0.05）,而 观察组术中出血量及输血量均小于对照组,差异具有统计学意义（P<0.05）;术后观察组血液中谷丙转氨酶（ALT）、谷草转氨酶 （AST）和总胆红素（TB）水平均低于对照组,而血清蛋白（ALB）和血红蛋白（Hb）水平高于对照组,差异均有统计学意义（均P<0. 05）;观察组并发症发生率为22.5%,明显低于对照组的37.5%,差异有统计学意义（P<0.05）。结论：SPVE法应用在肝癌合并门脉 高压手术中,可以显著减少术中的出血量和输血量,有利于术后肝功能的恢复,有效地降低术后并发症的发生。