经颅磁刺激联合语言训练对儿童语言发育迟缓的应用价值

目的:探讨经颅磁刺激联合语言训练对儿童语言发育迟缓的应用价值。方法:选取2015年3月-2016年3月我院收治的100例语言发育迟缓儿童作为本次研究的对象,采用随机数字表法将患者分为对照组与观察组各50例,对照组采用常规语言训练治疗,观察组则采用经颅磁刺激联合语言训练治疗,两组疗程皆为3个月。根据汉语儿童语言发育迟缓评定法和儿童神经心理发育测试分别评价治疗效果以及治疗前后发育商的变化情况。结果:观察组治疗有效率为98.0%,显著高于对照组的87.0%(P0.05);治疗后1、2、3月两组语言发育商、发育商较治疗前均有了显著改善,且观察组显著优于对照组(P0.05);观察组发育商正常率为80.0%,显著高于对照组的66.0%(P0.05)。结论:经颅磁刺激联合语言训练疗效理想,能够有效改善语言发育迟缓儿童的发育商,值得在临床上推广。     

多切面法联合彩色多普勒超声在胎儿先天性心脏病诊断中的应用

目的:探讨多切面法联合彩色多普勒超声在胎儿先天性心脏病(congenital heart diseases,CHD)诊断中的应用价值。方法:采用多切面法联合彩色多普勒超声对2015年5月~2016年7月300例胎儿进行CHD筛查,并与随访的产后超声或尸解结果作对照。结果:300例胎儿经产前超声联合多切面法检出CHD胎儿20例,检出率为6.7%,经产后超声或尸解确诊14例:三尖瓣下移畸形1例,室间隔完整型完全性大动脉转位1例,完全性房室间隔缺损1例,室间隔完整型肺动脉瓣闭锁1例,双流入型单心室1例,共同动脉干Ⅰ型2例,单纯室间隔缺损2例,法洛氏四联症2例,主动脉弓缩窄1例,肺动脉瓣轻度狭窄1例,二尖瓣闭锁并共同动脉干1例;误诊为单纯室间隔缺损1例,误诊为法洛氏四联症1例,病例流失4例。产前超声联合多切面法对有、无高危因素的检出率分别为3.79%、13.48%,比较有统计学意义(P0.05)。产前超声联合多切面法诊断CHD的灵敏度为100%、特异度为99.66%、阳性预测值为80.00%、阴性预测值为100%。结论:多切面法联合彩色多普勒超声在胎儿CHD诊断中具有较高的应用价值。     

Neutrophil elastase inhibitor, sivelestat sodium hydrate prevents ischemia–reperfusion injury in the rat bladder

In the present study, we evaluated the effect of neutrophil elastase inhibitor, sivelestat sodium hydrate on ischemia–reperfusion injury in the rat bladder. Rat abdominal aorta was clamping with a small clip to induce ischemia–reperfusion injury in the bladder. Eight-week-old male Sprague Dawley rats were divided into four groups; sham-operated control rats, 30 min ischemia–60 min reperfusion (IR) rats, and IR rats treated with 15 or 60 mg/kg of sivelestat sodium hydrate. Sixty minutes prior to induction of ischemia, sivelestat sodium hydrate was administrated intraperitoneally. Real-time monitoring of blood flow and nitric oxide (NO) release were measured simultaneously with a laser Doppler flowmeter and an NO-selective electrode, respectively. The NO₂–NO₃ and malonaldehyde (MDA) concentrations were measured in the experimental urinary bladders. Clamping of the abdominal aorta, blood flow was rapidly decreased and NO release was gradually increased. After removing the clip, blood flow was rapidly increased and NO release was gradually returned to the basal level. These movements of blood flow and NO release were inhibited by treatment with sivelestat sodium hydrate in a dose-dependent manner. Both NO₂–NO₃ and MDA concentrations in the bladder were increased by induction of IR, and NO₂–NO₃ and MDA concentrations were decreased by treatment with high dose of sivelestat sodium hydrate significantly. Our data indicated that sivelestat sodium hydrate could inhibit increasing NO₂–NO₃ and MDA concentrations by IR, and it has potentiality protective effects on IR injury in the rat urinary bladder.     

Doppler evaluation of maternal and foetal vessels during normal gestation in queen

The aim of this work is to evaluate the haemodynamic characteristics of maternal and foetal vessels during normal pregnancy in queens, using colour Doppler and pulsed wave Doppler ultrasonography, in order to obtain information about maternal and foetal circulation. The blood waveforms of the uteroplacental arteries, aorta, caudal cava vein and umbilical cord of the fetuses were recorded weekly in seven healthy pregnant queens. Also, the measurements of peak systolic, end diastolic velocities, resistance and pulsatility indices were carried out. Uteroplacental blood flow was biphasic while the ones of the umbilical artery and aorta were first systolic and then diastolic. The caudal cava vein showed a typical waveform of venous vessels. During gestation the EDV and PSV of foetal vessels increased ( < 0.05) while the PI and RI of all vessels examined decreased ( < 0.05) except for the IP of the aorta. The Doppler ultrasonography, also in queens, can be used to evaluate the characteristics of maternal and foetal vessel flow and their progressive changes during pregnancy. This study can be considered the basis for further contribution in diagnosing and monitoring high-risk pregnancies in Veterinary Medicine.     

经颅磁刺激在大脑皮质研究中的应用和进展

经颅磁刺激（TMS）是一种能够在脑中感应聚焦电流,瞬间调制大脑皮质的无创方法,在临床研究、基础神经学和诊治疾病等方面有许多应用。通过记录运动皮质诱发电位（MEPs),TMS已经或将成为探测脑下运动路径传导、评价皮质兴奋性、皮质映射和研究皮质塑性的常规工具。TMS能够主动干预脑功能,这种特性使它成为研究正常人脑－行为关系的独特技术,可以建立脑活动与任务完成之间的因果关系,探索脑功能连接。近年来的许多实验又表明,TMS在运动紊乱和精神疾病方面有潜在的治疗作用,但达到临床应用还有一定距离。     

钼靶X射线与彩色多普勒超声对乳腺癌的影像学特征及诊断价值比较分析

摘要 目的：探讨乳腺癌患者钼靶X射线与彩色多普勒超声（CDUs）的影像学特征及联合应用的诊断价值。方法：前瞻性选取 2018年1月至2021年6月收入安徽医科大学附属巢湖医院且疑似为乳腺癌患者120例,所有患者均接受钼靶X射线与CDUs技术检查,以手术病理为金标准,分别观察钼靶X射线与CDUs对不同大小乳腺癌的诊断价值、比较乳腺癌钼靶X射线与CDUs的影像特征,探讨钼靶X射线及CDUs单独应用及联合应用的诊断效能。结果：120例患者确诊乳腺癌者106例,证实为良性病变者14例。对于不同直径的乳腺癌诊断比较中,CDUs检查直径<1 cm病灶31个（29.25%）,钼靶X射线检查直径<1 cm病灶23个（21.70%）,组间比较具有统计学差异（P<0.05）;对于直径>3 cm病灶,钼靶X射线检查22个（20.75%）,CDUs检查为14个（13.21%）,组间比较具有统计学差异（P<0.05）。乳腺癌钼靶X射线与CDUs的影像特征比较显示,钼靶X射线对于点状微小钙化检查72个（67.92%）、边缘模糊伴毛刺病灶检查84个（79.25%）,二者征象检出率明显高于CDUs检查40个（37.36%）、47个（44.34%）,组间比较具有统计学差异（P<0.05）;CDUs对于肿块影检查个（76.42%）、增粗血管影或血流信号异常病灶检查79个（74.53%）,二者征象检出率明显高于钼靶X射线检查54（50.94%）个、57（53.77%）个,组间比较具有统计学差异（P<0.05）。钼靶X射线及CDUs诊断效能研究显示钼靶X射线联合CDUs技术检查的敏感度、特异度、准确度、阴性预测值（NPV）以及阳性预测值（PPV）分别为93.40%、93.41%、95.83%、64.29%及76.98%,均高于钼靶X射线的83.02%、88.89%、80.19%、15.81%及51.88%,亦高于CDUs技术的78.30%、75.47%、85.83%、28.57%及30.98%,多组数据单因素方差分析具有统计学差异（P<0.05）。结论：钼靶X射线与CDUs技术在诊断乳腺癌方面各有优缺点,二者联合检查利于提升对乳腺癌的诊断准确性,减少误诊漏诊的情况发生。     

A multipixel diffuse correlation spectroscopy system based on a single photon avalanche diode array

The autocorrelation of laser speckles from coherent near infrared light is used for noninvasive estimates of relative changes in blood perfusion in techniques such as laser Doppler flowmetry (LDF) and diffuse correlation spectroscopy (DCS). In this study, a 2D array of single photon avalanche diodes (SPADs) was used to combine the strengths of multiple detectors in LDF with high light sensitivity in DCS. The system was tested on milk phantoms with varying detector fiber diameter (200 and 600 μm), source‐detector fiber separation (4.6‐10.2 mm), fiber‐SPAD distance (2.5‐36.5 mm), contiguous measurement time per repetition for the autocorrelation (1‐33 ms) and temperature (15.6‐46.7°C). An in vivo blood occlusion test was also performed. The multipixel approach improved signal‐to‐noise ratio (SNR) and, in our setup, the use of a multimode detector fiber was beneficial for SNR. In conclusion, the multipixel system works, but improvements and further studies regarding, for example, the data acquisition and optimal settings are still needed.      

心脏彩超评估高血压左心室肥厚伴左心衰竭患者心功能的临床价值及与NYHA分级的关系研究

目的:探讨心脏彩超评估高血压左心室肥厚(LVH)伴左心衰竭患者心功能的临床价值,分析其超声指标与美国纽约心脏病协会(NYHA)分级的相关性。方法:选择2017年5月至2018年5月我院收治的127例高血压LVH伴左心衰竭患者为观察组,根据NYHA分级将其分为NYHAⅡ级组(41例)、Ⅲ级组(47例)、Ⅳ级组(39例),另选择100例体检的健康志愿者为对照组。所有受试者均接受心脏彩超获得相关参数[左心房内径(LAD)、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、左心室短轴缩短率(LVFS)、左心室后壁厚度(LVPWT)、室间隔厚度(IVST)、左心室射血分数(LVEF)、左心室舒张早期充盈峰最大充盈速度/舒张晚期充盈峰最大峰值速度(E/A)比值、Tei指数],分析心脏彩超相关参数与NYHA分级之间相关性。结果:观察组患者LAD、LVEDD、LVESD、LVPWT、IVST、Tei指数高于对照组(P0.05),LVFS、LVEF、E/A比值低于对照组(P0.05)。Tei指数随着NYHA分级增高而增高(P0.05),LVFS、LVEF、E/A比值随着NYHA分级增高而降低(P0.05)。Spearman秩相关分析结果显示,Tei指数与NYHA分级呈正相关(rs=0.398,P0.05),LVFS、LVEF、E/A比值与NYHA分级呈负相关(rs=-0.285,-0.442,-0.305,P0.05)。结论:高血压LVH伴左心衰竭患者发生明显左室肥厚和左心功能降低,心脏彩超可准确评估高血压LVH伴左心衰竭患者的心功能和病情严重程度,且部分心脏彩超相关参数与NYHA分级相关。     

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。     

基于三维彩色血管能量成像的子宫肌瘤射频消融的临床研究

目的：探讨三维彩色血管能量成像（three-dimensional color power angiography,3D-CPA）在射频消融（radiofrequency ablation ,RFA）子宫肌瘤中的应用价值。方法：回顾性分析于我院行RFA 治疗的48 例子宫肌瘤患者,比较3D-CPA、CDFI(color Doppler flow imaging) 两种方法指导下肌瘤血流分级、血管形态显示、初次消融时间、消融针数、完全消融率。根据超声造影 （contrast-enhanced ultrasound ,CEUS）结果对两组瘤体中消融不全的部分补充消融,记录两组的消融时间、消融针数并比较整个治 疗过程的消融时间、消融针数。结果：3D-CPA、CDFI在显示血流分级、血管形态上差异有统计学意义(P＜0.05)。初次治疗后, 3D-CPA 组92.3%(21/24)瘤体无造影剂灌注,CDFI组有68.2%（15/22）瘤体无造影剂灌注。二者比较差异有统计学意义（P＜0.05）。 整体消融过程中两组瘤体均达到完全消融时,3D-CPA组消融时间为（22.42± 0.68）min,消融针数为（5.04± 0.27）针,而CDFI 组 消融时间为（27.0± 2.34）min,消融针数为（6.09± 0.46）针,两组间差异均有统计学意义(P＜0.05)。结论：基于3D-CPA 可以显示子 宫肌瘤内外血管数目、形态用以指导射频消融治疗子宫肌瘤的价值优于CDFI指导射频消融术。