急性阑尾炎的超声诊断讨论

目的急性阑尾炎是外科急腹症中最常见的疾患,临床表现虽有一定的规律性,但有时变化多端,如果处理不当,可出现严重的并发症。探讨各型阑尾炎声像图特征,进一步提高超声诊断符合率。本文报道对116例经过手术病理证实的阑尾炎的超声检查进行分析。方法全部病例术前进行常规超声检查,并经过手术治疗。结果116例患者中有69例与超声直接征象相符,23例与超声间接征象相符,4例误诊,20例漏诊。结论超声在诊断急性急性阑尾炎和其他急腹症的鉴别诊断中具有重要作用,也不能忽略间接征象,以提高诊断符合率。     

膝关节交叉韧带重建术后早期综合康复治疗效果

目的探讨膝关节交叉韧带重建术后早期综合康复治疗治疗效果。方法通过对我院2007年6月至2010年5月收治的60例膝交叉韧带损伤的患者行膝关节镜手术后的早期功能锻炼的效果总结。结论早期功能锻炼可以促进膝关节镜下交叉韧带损伤术后患者功能的恢复,改善关节活动度。     

69例宫外孕超声诊断分析

目的旨在探讨宫外孕的超声诊断声像图的特征,为临床诊断提供可靠依据。方法取我院2006年以来应用超声诊断的69例宫外孕结合临床、手术及病理检查结果进行简要分析。结果超声诊断的69例宫外孕中,经手术及病理证实确诊为66例,诊断符合率为95.6%;误诊为3例,占4.4%。结论超声检查宫外孕可给临床提供准确率很高的诊断的依据,它具有简便直观、迅速、敏感性高、无损伤及易于重复等优点,所以超声应作为宫外孕诊断的首选方法。     

急诊超声在腹腔脏器破裂、内出血的应用价值

目的探讨超声检查在腹部闭合性损伤合并内脏损伤中的应用价值。方法回顾性总结和分析我院7年来81例闭合性腹部损伤合并内脏损伤的声像图表现。结果与手术及病理结果对照分析,81例除6例保守治疗外均经手术证实。结论B超对闭合性腹部损伤合并实质性内脏损伤的敏感性高,特异性较强,可作为早期诊断的首选方法。     

几种特殊类型前置胎盘超声诊断

目的探讨几种特殊类型前置胎盘超声诊断,对临床处理的意义。方法回顾性分析妊娠晚期前置胎盘15例超声诊断资料。结果本组经超声诊断患者15例,凶险型前置胎盘并出血6例,副胎盘前置2例,环状胎盘前置1例,膜状胎盘前置1例,帆状胎盘前置血管破裂5例。结论超声检查是诊断前置胎盘的重要手方法,及时发现问题并及时处理,尽最大限度保障母婴平安。     

阑尾占位性病变的超声诊断及临床意义

目的探讨超声检查在阑尾占位性病变诊断中的应用价值。方法回顾性分析2000～2008年,我院经手术病理证实的阑尾占位性病变25例,患者的临床及超声与CT等影像表现资料,分析其临床及影像表现特点。结果25例阑尾黏液腺癌22例(男、女各11例);阑尾黏液性囊腺瘤2例,阑尾黏液囊肿1例。结论超声检查能及时协助临床对阑尾占位性病变等进行诊断及鉴别诊断,有效提高手术前的诊断准确率。     

B超在腹部闭合性损伤诊断中的应用价值分析

目的探讨B超检查在腹部闭合性损伤中的临床诊断价值。方法回顾性分析我院2005年2月至2010年8月住院采用B超检查并经手术证实后的腹部闭合性损伤患者共127例,探讨分析其对腹部闭合性损伤的诊断价值。结果 127例患者中,B超检查诊断与最终的手术结果对照显示符合108例,诊断符合率为85.8%。结论 B超检查在是腹腔闭合性损伤的首选的诊断方法。     

浅表超声对乳腺微小钙化的观察与分析

目的:观察与分析浅表超声对乳腺微小钙化的检出情况.方法:回顾性分析124例乳腺肿块患者的临床资料,所有患者均经手术病理诊断和浅表超声检查,分析浅表超声对乳腺微小钙化的检出情况、良恶性病变的诊断符合率、检出乳腺微小钙化的病理类型.结果:124例乳腺肿块患者的乳腺微小钙化检出32例;其中良性病变4例,占7.14%;恶性病变28例,占41.18%;经χ2检验,乳腺肿块良性病变与恶性病变患者的乳腺微小钙化检出率差异具有统计学意义(P<0.05);浅表超声与手术病理诊断相符110例,占88.71%;其中良性病变符合率为87.50%(49/56),恶性病变符合率为89.71%(61/68);使用7.5MHz超声探头扫查,均能检出乳腺微小钙化病灶.结论:浅表超声对乳腺微小钙化的检出效果显著,钙化灶后不伴有声影作为诊断乳腺肿块恶性病变的重要依据.     

62例三踝骨折合并下胫腓联合损伤患者的手术治疗

目的探讨三踝骨折合并下胫腓联合损伤患者的手术治疗。方法回顾分析62例三踝骨折合并下胫腓联合损伤采用可吸收螺钉配合聚酯韧带治疗的患者的临床资料。结果25例患者随访6个月～1年,优40例,良15例,差7例,优良率为88.7%。结论三踝骨折合并下胫腓联合损伤手术治疗的关键是恢复并稳定踝穴和距骨的解剖关系,可吸收螺钉配合聚酯韧带治疗固定牢固,有利于早期功能锻炼。     

超声心动在产前诊断胎儿先天性心脏病的临床价值探讨

目的探讨超声心动在产前诊断胎儿先天性心脏病的临床价值和意义。方法对我院收治的48例有高危倾向的孕妇进行胎儿超声心动检查,并对其结果进行分析。结果共检出心脏异常39例,检出率为81.3%,均在孕24周后诊断出。其中室间隔缺损11例,法络四联症8例,心内膜垫缺损3例,心肌肥厚5例,肺动脉狭窄2例,心脏粘液瘤4例,心脏缩小2例,心包积液4例。孕妇均终止妊娠,检查与产前检查相符。结论超声心动在诊断先天性心脏病方面具有广泛的临床应用价值,可作为临床筛查胎儿先天性心脏病的首选方法。     

Anti-Inflammatory Therapeutic Approaches to Prevent or Delay Post-Traumatic Osteoarthritis (PTOA) of the Knee Joint with a Focus on Sustained Delivery Approaches

Inflammation plays a central role in the pathogenesis of knee PTOA after knee trauma. While a comprehensive therapy capable of preventing or delaying post-traumatic osteoarthritis (PTOA) progression after knee joint injury does not yet clinically exist, current literature suggests that certain aspects of early post-traumatic pathology of the knee joint may be prevented or delayed by anti-inflammatory therapeutic interventions. We discuss multifaceted therapeutic approaches that may be capable of effectively reducing the continuous cycle of inflammation and concomitant processes that lead to cartilage degradation as well as those that can simultaneously promote intrinsic repair processes. Within this context, we focus on early disease prevention, the optimal timeframe of treatment and possible long-lasting sustained delivery local modes of treatments that could prevent knee joint-associated PTOA symptoms. Specifically, we identify anti-inflammatory candidates that are not only anti-inflammatory but also anti-degenerative, anti-apoptotic and pro-regenerative.     

E8002 Reduces Adhesion Formation and Improves Joint Mobility in a Rat Model of Knee Arthrofibrosis

Knee arthrofibrosis is a common complication of knee surgery, caused by excessive scar tissue, which results in functional disability. However, no curative treatment has been established. E8002 is an anti-adhesion material that contains L-ascorbic acid, an antioxidant. We aimed to evaluate the efficacy of E8002 for the prevention of knee arthrofibrosis in a rat model, comprising injury to the surface of the femur and quadriceps muscle 1 cm proximal to the patella. Sixteen male, 8-week-old Sprague Dawley rats were studied: in the Adhesion group, haemorrhagic injury was induced to the quadriceps and bone, and in the E8002 group, an adhesion-preventing film was implanted between the quadriceps and femur after injury. Six weeks following injury, the restriction of knee flexion owing to fibrotic scarring had not worsened in the E8002 group but had worsened in the Adhesion group. The area of fibrotic scarring was smaller in the E8002 group than in the Adhesion group (p < 0.05). In addition, the numbers of fibroblasts (p < 0.05) and myofibroblasts (p < 0.01) in the fibrotic scar were lower in the E8002 group. Thus, E8002 reduces myofibroblast proliferation and fibrotic scar formation and improves the range of motion of the joint in a model of knee injury.     

Potential of Exosomes for Diagnosis and Treatment of Joint Disease: Towards a Point-of-Care Therapy for Osteoarthritis of the Knee

In the knee joint, articular cartilage injury can often lead to osteoarthritis of the knee (OAK). Currently, no point-of-care treatment can completely address OAK symptoms and regenerate articular cartilage to restore original functions. While various cell-based therapies are being developed to address OAK, exosomes containing various components derived from their cells of origin have attracted attention as a cell-free alternative. The potential for exosomes as a novel point-of-care treatment for OAK has been studied extensively, especially in the context of intra-articular treatments. Specific exosomal microRNAs have been identified as possibly effective in treating cartilage defects. Additionally, exosomes have been studied as biomarkers through their differences in body fluid composition between joint disease patients and healthy subjects. Exosomes themselves can be utilized as a drug delivery system through their manipulation and encapsulation of specific contents to be delivered to specific cells. Through the combination of exosomes with tissue engineering, novel sustained release drug delivery systems are being developed. On the other hand, many of the functions and activities of exosomes are unknown and challenges remain for clinical applications. In this review, the possibilities of intra-articular treatments utilizing exosomes and the challenges in using exosomes in therapy are discussed.     

Do Synovial Inflammation and Meniscal Degeneration Impact Clinical Outcomes of Patients Undergoing Arthroscopic Partial Meniscectomy? A Histological Study

The menisci exert a prominent role in joint stabilization and in the distribution of mechanical loading. Meniscal damage is associated with increased risk of knee OA. The aim of this study was to characterize the synovial membrane and meniscal tissues in patients undergoing arthroscopic partial meniscectomy for meniscal tear and to evaluate association with clinical outcomes. A total of 109 patients were recruited. Demographic and clinical data were collected. Visual Analogic Scale (VAS) measuring pain and Knee injury and Osteoarthritis Outcome Score (KOOS) were recorded at baseline and at 2-years follow-up. Histological and immunohistochemical characterizations were performed on synovial membranes and meniscal tissues. More than half of the patients demonstrated synovial mononuclear cell infiltration and hyperplasia. Synovial fibrosis was present in most of the patients; marked vascularity and CD68 positivity were observed. Inflammation had an impact on both pain and knee symptoms. Patients with synovial inflammation had higher values of pre-operative VAS and inflammation. Higher pre-operative pain was observed in patients with meniscal MMP-13 production. In conclusion, multivariate analysis showed that synovial inflammation was associated with pre-operative total KOOS scores, knee symptoms, and pain. Moreover, meniscal MMP-13 expression was found to be associated with pre-operative pain in multivariate analysis. Thus, targeting inflammation of the synovial membrane and meniscus might reduce clinical symptoms and dysfunction at the time of surgery.     

超声诊断不同类型异位妊娠120例的临床应用

目的分析超声诊断不同类型异位妊娠的临床价值。方法选择我院2007年6月至2010年6月收治的120例经超声确诊的异位妊娠患者作为研究对象,采用美国GE-LOGIQ-400、Acuson128XP/10c彩色多普勒超声诊断仪。彩色多普勒超声诊断仪进行检查,总结分析不同类型异位妊娠的超声声像图表现。结果超声诊断的120例异位妊娠患者,经手术及病理证实者112例,诊断符合率93.3%。120例超声诊断的异位妊娠患者中,未破型、破裂型、流产型、陈旧型异位妊娠患者的超声声像图表现均有其自身的特点。结论超声对异位妊娠的诊断符合率较高,不同类型的异位妊娠超声声像图具有不同的特点,因此,临床诊断异位妊娠时同时结合HCG及患者自身的因素而确诊。     

35例膝骨关节炎患者软骨厚度的超声检查

目的本文探讨了超声波在膝骨关节炎的诊断中价值和意义,用超声波检测膝骨关节炎患者软骨的厚度。方法对70个患骨关节炎的膝关节不同部位软骨厚度,包括滑车中央沟,股骨髁前方、负重区、后方7个部位进行超声波测量。并取10例20个正常膝关节软骨厚度作对照。结论高频超声波能够较准确地评价膝骨关节炎软骨厚度的变化。     

妇产科超声联合检查方式与图像效果探讨

目的：分析与探讨妇产科超声联合检查方式与图像效果。方法：选择在我院妇产科接受诊疗的4例典型患者,对其分别进行经腹超声检查及经阴道超声检查,并将检查结果进行对比。结果：经阴道超声检查可使子宫及附件处于常规位置,从而获得详细信息,但图像视窗具有局限性。经腹超声操作简单,能够为检查提供广泛的视野,但患者膀胱需足够充盈。结论：经腹超声与经阴道超声各具优势,妇产科临床中应结合两种超声超声检查结果进行综合诊断。     

Antioxidant Activity of the Phenolic Leaf Extracts from <Emphasis Type="Italic">Monechma ciliatum</Emphasis> in Stabilization of Corn Oil

The total phenolic content and the antioxidant potential of methanolic extract (ME), ethyl acetate extract (EAE), and hexane extract (HE) from Monechma ciliatum leaves (MCL) were evaluated. The Folin-Ciocalteu, β-carotene bleaching, the 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging and the accelerated oxidation methods were used for evaluation. Both the extraction yield and the antioxidant activity (AOA) were strongly dependent on the solvent. Among the extracts, ME exhibited highest total phenolic compounds (TPC) and IC₅₀ values for DPPH, followed by EAE and HE, respectively. Peroxide value (PV), anisidine value (AV) conjugated dienes (CD), and thiobarbituric acid reactive substances (TBARS) were taken as the parameters for evaluation of stabilization efficacy of MCL extracts and results revealed MCL to be a potent antioxidant for the stabilization of corn oil. As a general trend, increased AOA was observed for increased extract concentration. The predominant phenolic compounds identified by HPLC-DAD in MCL extracts were p-coumaric acid, vanillin and ferulic acid.     

Proteomic Analysis of the Meniscus Cartilage in Osteoarthritis

The distribution of differential extracellular matrix (ECM) in the lateral and medial menisci can contribute to knee instability, and changes in the meniscus tissue can lead to joint disease. Thus, deep proteomic identification of the lateral and medial meniscus cartilage is expected to provide important information for treatment and diagnosis of various knee joint diseases. We investigated the proteomic profiles of 12 lateral/medial meniscus pairs obtained from excess tissue of osteoarthritis patients who underwent knee arthroscopy surgery using mass spectrometry-based techniques and measured 75 ECM protein levels in the lesions using a multiple reaction monitoring (MRM) assay we developed. A total of 906 meniscus proteins with a 1% false discovery rate (FDR) was identified through a tandem mass tag (TMT) analysis showing that the lateral and medial menisci had similar protein expression profiles. A total of 131 ECM-related proteins was included in meniscus tissues such as collagen, fibronectin, and laminin. Our data showed that 14 ECM protein levels were differentially expressed in lateral and medial lesions (p < 0.05). We present the proteomic characterization of meniscal tissue with mass spectrometry-based comparative proteomic analysis and developed an MRM-based assay of ECM proteins correlated with tissue regeneration. The mass spectrometry dataset has been deposited to the MassIVE repository with the dataset identifier MSV000087753.     

Small Noncoding RNAs in Knee Osteoarthritis: The Role of MicroRNAs and tRNA-Derived Fragments

Knee osteoarthritis (OA) is a degenerative knee joint disease that results from the breakdown of joint cartilage and underlying bone, affecting about 3.3% of the world’s population. As OA is a multifactorial disease, the underlying pathological process is closely associated with genetic changes in articular cartilage and bone. Many studies have focused on the role of small noncoding RNAs in OA and identified numbers of microRNAs that play important roles in regulating bone and cartilage homeostasis. The connection between other types of small noncoding RNAs, especially tRNA-derived fragments and knee osteoarthritis is still elusive. The observation that there is limited information about small RNAs different than miRNAs in knee OA was very surprising to us, especially given the fact that tRNA fragments are known to participate in a plethora of human diseases and a portion of them are even more abundant than miRNAs. Inspired by these findings, in this review we have summarized the possible involvement of microRNAs and tRNA-derived fragments in the pathology of knee osteoarthritis.