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Positron emission tomography/computed tomography imaging appearance of benign and classic "do not touch" osseous lesions 预览
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作者 Stacey M Elangovan Ronnie Sebro 《世界放射学杂志:英文版(电子版)》 2019年第6期81-93,共13页
BACKGROUND Classic “do not touch” and benign osseous lesions are sometimes detected on 18-Ffluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) studies. These lesions are often refe... BACKGROUND Classic “do not touch” and benign osseous lesions are sometimes detected on 18-Ffluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) studies. These lesions are often referred for biopsy because the physician interpreting the PET/CT may not be familiar with the spectrum of 18F-FDG uptake patterns that these lesions display. AIM To show that “do not touch” and benign osseous lesions can have increased 18FFDG uptake above blood-pool on PET/CT;therefore, the CT appearance of these lesions should dictate management rather than the standardized uptake values (SUV). METHODS This retrospective study evaluated 287 independent patients with 287 classic “do not touch”(benign cystic lesions, insufficiency fractures, bone islands, bone infarcts) or benign osseous lesions (hemangiomas, enchondromas, osteochondromas, fibrous dysplasia, Paget’s disease, osteomyelitis) who underwent 18F-FDG positron emission tomography/computed tomography (PET/CT) at a tertiary academic healthcare institution between 01/01/2006 and 12/1/2018. The maximum and mean SUV, and the ratio of the maximum SUV to mean blood pool were calculated. Pearson’s correlations between lesion size and maximum SUV were calculated. RESULTS The ranges of the maximum SUV were as follows: For hemangiomas (0.95-2.99), bone infarcts (0.37-3.44), bone islands (0.26-3.29), enchondromas (0.46-2.69), fibrous dysplasia (0.78-18.63), osteochondromas (1.11-2.56), Paget’s disease of bone (0.93-5.65), insufficiency fractures (1.06-12.97) and for osteomyelitis (2.57- 12.64). The range of the maximum SUV was lowest for osteochondromas (maximum SUV 2.56) and was highest for fibrous dysplasia (maximum SUV of 18.63). There was at least one lesion that demonstrated greater 18F-FDG avidity than the blood pool amongst each lesion type, with the highest maximum SUV ranging from 9.34 times blood pool mean (osteomyelitis) to 1.42 times blood pool mean (hemangiomas). There was no correlation between the maximum SUV and the lesion s 展开更多
关键词 Positron emission tomography/computed tomography Skeletal-axial Skeletal-appendicular “Do not touch” LESIONS
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生长激素缺乏症对心血管系统病变的影响分析 预览
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作者 张艳芳 韩雪 《数理医药学杂志》 2019年第1期56-57,共2页
目的:探讨机体的生长素缺乏症对心血管系统的影响。方法:将60例患有生长素缺乏症的患者分为两组,生长素缺乏症治疗组为A组,生长素缺乏症未治疗组为B组,比较两组心血管疾病的发生率。结果:A组心血管疾病的发生率明显低于B组(P<0.05),... 目的:探讨机体的生长素缺乏症对心血管系统的影响。方法:将60例患有生长素缺乏症的患者分为两组,生长素缺乏症治疗组为A组,生长素缺乏症未治疗组为B组,比较两组心血管疾病的发生率。结果:A组心血管疾病的发生率明显低于B组(P<0.05),有统计学意义。结论:生长激素缺乏症会增加心血管疾病的发病率、死亡率,导致机体心脏结构及功能损害、脂质代谢异常,内皮细胞功能紊乱,危害机体健康。 展开更多
关键词 生长激素缺乏症 心血管系统 病变
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单独病灶清除术或联合植骨融合外固定术治疗膝关节结核的临床疗效 预览
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作者 霍永超 沈生军 +2 位作者 徐尚胜 王春伟 黄贵成 《西部医学》 2019年第1期70-73,79共5页
目的探讨单独病灶清除术或联合植骨融合外固定术治疗膝关节结核的临床疗效。方法选取2014年1月~2016年1月期间收治入院的膝关节结核患者83例,按照随机数字表法将其分为单独结核病灶清除术组39例(单独组)和病灶清除联合植骨融合外固定术... 目的探讨单独病灶清除术或联合植骨融合外固定术治疗膝关节结核的临床疗效。方法选取2014年1月~2016年1月期间收治入院的膝关节结核患者83例,按照随机数字表法将其分为单独结核病灶清除术组39例(单独组)和病灶清除联合植骨融合外固定术组44例(联合组)。对比两组手术时间、住院时间、术中出血量情况及术后低蛋白血症及贫血发生情况,并观察两组患者手术前后膝关节功能评分、生理健康及心理健康评分情况。结果术前组间膝关节功能评分无统计学差异,术后两组患者整体膝关节功能变化均存在统计学差异(F值分别为126.356和82.032,P均<0.01)。且术后不同时间点单独组膝关节功能评分显著较联合组高,组间差异显著(P<0.05)。术前组间生理健康评分及心理健康评分差异无统计学意义(P >0.05),术后3个月生理健康评分及心理健康评分单独组均显著高于联合组。单独组手术时间及住院时间较联合组短,术中出血量较联合组少,组间差异有显著性(P<0.05),且单独组术后低蛋白血症及贫血发生率较联合组低,组间差异有统计学意义(P<0.05)。单独组术后18个月随访复发率10.26%,联合组11.36%,组间差异无统计学意义(P >0.05)。结论两种方法术后患者膝关节功能及生活质量均得到有效改善,且对术后复发无影响。相较而言,单纯膝关节结核病灶清除术组手术时间更短,术后恢复更快。膝关节结核采用单纯结核病灶清除术或联合植骨融合外固定术治疗均可有效改善患者膝关节功能及生活质量,故术式的选择应结合患者病情严重程度决定,继而提高疗效,促进术后康复。 展开更多
关键词 膝关节结核 病灶清除术 植骨融合外固定术 临床疗效
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Effects of Early Weightbearing on Microfracture Treatment of Osteochondral Lesions of Talus with Subchondral Bone Defects 预览
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作者 Min WEI Yu WEI Yang LIU 《当代医学科学(英文)》 SCIE CAS 2019年第1期88-93,共6页
When subchondral bone defects are present in osteochondral lesions of the talus(OCLT),it is inconclusive whether to allow early weightbearing after microfracture treatment because of the lack of effective support of t... When subchondral bone defects are present in osteochondral lesions of the talus(OCLT),it is inconclusive whether to allow early weightbearing after microfracture treatment because of the lack of effective support of the newly-formed fibrocartilage.After performing arthroscopic debridement and microfracture treatment on OCLT patients with subchondral bone defects,we allowed patients to have an early postoperative weightbearing exercise to observe their clinical outcome.Forty-two OCLT patients with subchondral bone defects were analyzed.Patients were randomly divided into two groups with 21 patients in each group.After arthroscopic debridement and microfracture treatment,group A was allowed to have early partial weightbearing while weightbearing was delayed in group B.Visual analogue scale(VAS)was used to evaluate joint pain before and after surgery.American Orthopaedic Foot and Ankle Society(AOFAS)anklc-hindfoot score was used to evaluate joint function.Tegner activity scale was used to assess patient's exercise level.The AOFAS ankle-hindfoot score in group A increased from 54.4 to 87.6,and that in group B increased from 54.9 to 87.3.The VAS score in group A decreased from 6.5 to 2.2,and that in group B decreased from 6.4 to 2.3.The Tegner activity scale increased from 2.6 to 4.4 in group A,and that in group B increased from 2.6 to 3.9.There was significant difference in the Tegner activity scale between group A and group B(P<0.05).It was suggested that when performing microfracture treatmenf on OCLT patients with subchondral bone defects,early postoperative weightbearing may achieve similar clinical outcomes as delayed weightbearing,and patients may be better able to return to sports. 展开更多
关键词 OSTEOCHONDRAL LESIONS of the TALUS subchondral BONE ARTHROSCOPIC MICROFRACTURE weightbearing time
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Identifying high-risk individuals for gastric cancer surveillance from western and eastern perspectives: Lessons to learn and possibility to develop an integrated approach for daily practice 预览
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作者 Duc Trong Quach Toru Hiyama Takuji Gotoda 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第27期3546-3562,共17页
Current evidence shows that individuals with gastric dysplasia, severe and extensive gastric atrophy, extensive gastric intestinal metaplasia and the incomplete subtype of intestinal metaplasia are at high risk for ga... Current evidence shows that individuals with gastric dysplasia, severe and extensive gastric atrophy, extensive gastric intestinal metaplasia and the incomplete subtype of intestinal metaplasia are at high risk for gastric cancer(GC) development. There are several approaches to identifying these subjects,including noninvasive methods, esophagogastroduodenoscopy and histology.The main approach in Western countries is histology-based while that in Eastern countries with a high prevalence of GC is endoscopy-based. Regarding asymptomatic individuals, the key issues in selecting applicable approaches are the ability to reduce GC mortality and the cost-effectiveness of the approach. At present, population-based screening programs have only been applied in a few Asian countries with a high risk of GC. Pre-endoscopic risk assessment based on demographic and clinical features, such as ethnicity, age, gender, smoking and Helicobacter pylori status, is helpful for identifying subjects with high pre-test probability for a possibly cost-effective approach, especially in intermediate-and low-risk countries. Regarding symptomatic patients with indications for esophagogastroduodenoscopy, the importance of opportunistic screening should be emphasized. The combination of endoscopic and histological approaches should always be considered as endoscopy provides a real-time assessment of the patient’s risk level. In addition, imaging enhanced endoscopy(IEE) has been shown to facilitate targeted biopsies resulting in better correlation between endoscopic and histological findings. Currently, the use of IEE is recommended for endoscopic examinations, and the Operative Link for Gastric Intestinal Metaplasia or Operative Link on Gastritis Assessment grading systems are recommended for histological examinations whenever available. However,resource limitations are an important barrier in many regions worldwide. Thus,for an approach to be applicable in real-life practice, it should be not only evidence-based but also resource-sensitive. In 展开更多
关键词 GASTRIC cancer PRECANCEROUS GASTRIC lesions Dysplasia GASTRIC ATROPHY Chronic ATROPHIC gastritis Intestinal METAPLASIA SURVEILLANCE Screening Costeffective
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Endoscopic ultrasound-guided fine-needle aspiration biopsy - Recent topics and technical tips 预览
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作者 Kazuya Matsumoto Yohei Takeda +5 位作者 Takumi Onoyama Soichiro Kawata Hiroki Kurumi Hiroki Koda Taro Yamashita Hajime Isomoto 《世界临床病例杂志》 2019年第14期1775-1783,共9页
Endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNA) is a useful procedure that enables reliable pathological diagnoses of pancreatobiliary diseases, subepithelial lesions, and swollen lymph nodes. In ... Endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNA) is a useful procedure that enables reliable pathological diagnoses of pancreatobiliary diseases, subepithelial lesions, and swollen lymph nodes. In recent years, a pathological diagnosis based on EUS-FNA has made it possible to provide accurate treatment methods not only in these fields, but also in respiratory organs and otorhinolaryngology. This review discusses the latest topics pertaining to EUS-FNA as well as procedural tips. 展开更多
关键词 Endoscopic ULTRASOUND-GUIDED FINE-NEEDLE ASPIRATION BIOPSY CYTOLOGY Pathology Pancreatobiliary diseases Subepithelial lesions Lymph nodes
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Efficacy of endoscopic treatment on patients with severe dysplasia/carcinoma in situ of esophageal squamous cell carcinoma: A prospective cohort study 预览
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作者 Meng Wang Changqing Hao +5 位作者 Shuanghua Xie Shanrui Ma Rongshou Zheng Ru Chen Xinqing Li Wenqiang Wei 《中国癌症研究:英文版》 SCIE CAS CSCD 2019年第2期357-365,共9页
Objective: To explore the natural history of severe dysplasia/carcinoma in situ(SD/CIS) patients and to evaluate the efficacy of endoscopic treatment to SD/CIS patients.Methods: Between January 2005 and December 2009,... Objective: To explore the natural history of severe dysplasia/carcinoma in situ(SD/CIS) patients and to evaluate the efficacy of endoscopic treatment to SD/CIS patients.Methods: Between January 2005 and December 2009, a population-based prospective screening program on esophageal squamous cell carcinoma(ESCC) was performed in Linzhou, China, with endoscopic screening plus iodine staining. All the eligible histologically confirmed SD/CIS patients were followed up through the door-todoor follow-up and local cancer registry. The endpoint was diagnosed as ESCC or the December 31 st, 2016.Kaplan-Meier survival analysis and Log-rank test were used to compare the survival rates among treated and untreated patients.Results: A total of 175 SD/CIS patients were enrolled and grouped by whether they received endoscopic treatment. Eleven-year cumulative incidence rates for untreated and treated SD/CIS patients were 10.7%[95%confidence interval(95% CI): 6.9-16.1] and 3.2%(95% CI: 1.4-7.0), respectively. The ESCC incidence free survival rate, and all-cause incidence and mortality free survival rates were all significantly higher in the treated patients vs. untreated patients(P=0.043, P=0.008 and P=0.015, respectively). The ESCC mortality free survival rate showed no significant differences between the two groups(P=0.847).Conclusions: The cumulative incidence rate of SD/CIS patients to ESCC was much lower than previously reported. The Kaplan-Meier survival analysis showed that endoscopic treatment could increase the ESCC and allcause disease-free survival rates of SD/CIS patients significantly. 展开更多
关键词 Endoscopy ESOPHAGEAL SQUAMOUS cell carcinoma PRECANCEROUS LESIONS management mass screening
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Ⅱ型剖宫产疤痕妊娠手术方式的临床探讨 预览
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作者 赵英武 付婷 《实用临床医药杂志》 CAS 2019年第15期42-44,共3页
目的分析Ⅱ型剖宫产疤痕妊娠的最佳手术方式.方法选取120例Ⅱ型剖宫产疤痕妊娠患者,按不同术式分为A组(n=60)与B组(n=60).A组行宫-腹腔镜剖宫产疤痕妊娠病灶切除术联合子宫修补术,B组行宫腔镜剖宫产疤痕妊娠病灶切除术.比较2组患者手术... 目的分析Ⅱ型剖宫产疤痕妊娠的最佳手术方式.方法选取120例Ⅱ型剖宫产疤痕妊娠患者,按不同术式分为A组(n=60)与B组(n=60).A组行宫-腹腔镜剖宫产疤痕妊娠病灶切除术联合子宫修补术,B组行宫腔镜剖宫产疤痕妊娠病灶切除术.比较2组患者手术效果.结果A组手术时间、术中出血量、二次手术率低于B组,手术成功率高于B组,差异有统计学意义(P>0.05);2组恢复时间及并发症发生率比较无显著差异(P>0.05).结论对Ⅱ型剖宫产疤痕妊娠患者采取宫-腹腔镜剖宫产疤痕妊娠病灶切除术联合子宫修补术的效果确切. 展开更多
关键词 剖宫产疤痕妊娠 宫腔镜 腹腔镜 子宫修补术 并发症 病灶
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血清YKL-40与2型糖尿病视网膜病变、糖尿病肾病的关系 预览
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作者 林丽君 范培云 +7 位作者 姚勇利 罗玮 蒋艳苹 宋康 王淑琼 范晓霞 谢延玲 李亚楠 《中国高原医学与生物学杂志》 CAS 2019年第2期118-121,129共5页
目的探讨血清几丁质酶3样蛋白1(YKL-40)与2型糖尿病视网膜病变(DR)、糖尿病肾病(DKD)的关系。方法根据眼底检查、尿白蛋白/肌酐(ACR)结果分为无并发症的2型糖尿病(DM)组、非增殖期糖尿病视网膜病变(NPDR)组、增殖期糖尿病视网膜病变(PDR... 目的探讨血清几丁质酶3样蛋白1(YKL-40)与2型糖尿病视网膜病变(DR)、糖尿病肾病(DKD)的关系。方法根据眼底检查、尿白蛋白/肌酐(ACR)结果分为无并发症的2型糖尿病(DM)组、非增殖期糖尿病视网膜病变(NPDR)组、增殖期糖尿病视网膜病变(PDR)组和糖尿病肾病(DKD)组。同时,选取同期在同一医院体检的健康者作为对照(CG)组,通过测定YKL-40等指标,分析健康人、无并发症的2型糖尿病患者及病变程度不同的糖尿病微血管病变患者的血清YKL-40情况。结果1.DR患者血清YKL-40水平明显高于无并发症的T2DM患者,且随DR严重程度加重而升高,YKL-40是DR的独立危险因素;2.DKD患者血清YKL-40水平明显高于无并发症的T2DM患者,YKL-40是DKD的独立危险因素。结论血清YKL-40是2型糖尿病视网膜病变、糖尿病肾病的独立危险因素,与病情严重程度相关,且呈正相关关系。 展开更多
关键词 糖尿病 微血管 病变 炎症 YKL-40
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Assessment of optic nerve and optic tract alterations in patients with orbital space-occupying lesions using probabilistic diffusion tractography
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作者 Chun-Nan Wu Shao-Feng Duan +4 位作者 Xue-Tao Mu Yi Wang Peng-Yu Lan Xiao-Lu Wang Kun-Cheng Li 《国际眼科杂志:英文版》 SCIE CAS 2019年第8期1304-1310,共7页
AIM: To investigate the diffusion changes in both the optic nerve and optic tract in orbital space-occupying lesion patients with decreased visual acuity, and its clinical significance using probabilistic diffusion tr... AIM: To investigate the diffusion changes in both the optic nerve and optic tract in orbital space-occupying lesion patients with decreased visual acuity, and its clinical significance using probabilistic diffusion tractography(PDT). METHODS: Twenty patients with orbital space-occupying lesions and 25 age-and gender-matched healthy persons were included. All patients and controls underwent routine orbital magnetic resonance imaging and diffusion tensor imaging(DTI), using a 3.0 T magnetic resonance scanner(Trio Tim Siemens). After the image data were preprocessed, each DTI parameters of the optic nerve and optic tract was obtained by PDT, including fractional anisotropy(FA), mean diffusivity(MD), axial diffusivity(AD) and radial diffusivity(RD). The asymmetry index(AI) of each parameter was calculated. Compared the parameters of the affected side optic nerve and ipsilateral optic tract with the contralateral side by paired sample t-test;compared AI of parameters of optic nerve and optic tract between the patient group and the control group by independent sample t-test. Patients were divided into threesubgroups according to the low vision grade standard of WHO, compared the FA and AI of FA between the three subgroups by single factor variance analysis. RESULTS: The affected side optic nerve presented significantly decreased FA, increased MD, AD, and RD values compared to the unaffected side(P<0.05). The AI of FA, MD, AD, and RD of optic nerve in the patients was significantly higher than that of the controls(P<0.05). The comparison results of the optic tract showed that there was no significant difference between the patient group and control group in terms of the bilateral optic tracts in patients(P>0.05). The AIs of the FA value of the optic nerve in the eyesight <0.1 subgroup was significantly higher than that in the other groups(P<0.05). CONCLUSION: FA, MD, AD, and RD of the affected side optic nerve of the orbital space-occupying lesions have significantly changed, the FA value is the most sensitive. The PDT 展开更多
关键词 ORBITAL space-occupying lesions decreased vision OPTIC never and OPTIC tract PROBABILISTIC diffusion TRACTOGRAPHY magnetic resonance imaging
Atypical cutaneous lesions in advanced-stage Hodgkin lymphoma:A case report 预览
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作者 Fulvio Massaro Angela Ferrari +2 位作者 Enrico Zendri Magda Zanelli Francesco Merli 《世界临床病例杂志》 2019年第17期2513-2518,共6页
BACKGROUND Cutaneous involvement in Hodgkin lymphoma (HL) is a rare finding.Few cases have been reported in literature,most describing paraneoplastic manifestations.Only very few papers have described primary HL skin ... BACKGROUND Cutaneous involvement in Hodgkin lymphoma (HL) is a rare finding.Few cases have been reported in literature,most describing paraneoplastic manifestations.Only very few papers have described primary HL skin infiltration,reporting a wide range of clinical presentations that frequently include ulcers;plaques,nodules and papules have also been noticed.CASE SUMMARY We report the case of a 56-year-old man who presented fever,multiple adenomegalies of neck and axilla and thick serpiginous skin lesions involving bilateral pectoral regions.After an initial diagnostic workup for a suspected active infectious disease,a lymph node biopsy was performed,which showed a neoplastic invasion from a mixed cellularity classical HL.The same histological pattern was described in a cutaneous biopsy of the chest lesions.The other staging procedures performed revealed an advanced disease,with unfavourable clinical prognostic features.The patient was prescribed 6 cycles of ABVD chemotherapy scheme (doxorubicin,bleomycin,vinblastine,dacarbazine),a regiment that requires demonstration of metabolic response achievement at the interim PET/CT scan to confirm continuation or to change therapeutic strategy.CONCLUSION Skin involvement in HL is a rare finding and may represent a challenging clinical presentation due to extremely various types of lesions observed. 展开更多
关键词 HODGKIN lymphoma Skin LESIONS Advanced stage ABVD Case report
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Research Progress on the Relationship Between White Matter Lesions and Vascular Cognitive Impairment 预览
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作者 Wen-Jing Zhou Yao-Ming Xu 《心身医学研究》 2019年第2期26-31,共6页
As the incidence of cerebrovascular disease increases,the incidence of white matter lesions (WMLs) and vascular cognitive impairment (VCI) also increases.Ischemic WMLs is directly related to VCI,especially non-dementi... As the incidence of cerebrovascular disease increases,the incidence of white matter lesions (WMLs) and vascular cognitive impairment (VCI) also increases.Ischemic WMLs is directly related to VCI,especially non-dementia VCI.Early symptoms of non-dementia VCI are hidden and difficult to identify.About 50% of patients develop dementia.This article reviews the correlation between WMLs and VCI in terms of etiology,risk factors,pathogenesis and imaging manifestations.It provides scientific basis or ideas for clinical diagnosis and treatment for WMLs and VCI. 展开更多
关键词 WHITE MATTER LESIONS VASCULAR COGNITIVE IMPAIRMENT
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广州市1723例活动性肺结核患者门诊费用分析
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作者 赖静文 郭婉如 《中国热带医学》 CAS 2019年第7期659-661,666共4页
目的了解广州市番禺区活动性肺结核患者门诊费用构成,为制定和完善结核病控制策略、优化资源配置提供依据。方法以2016—2018年在番禺区慢性病防治站登记管理并完成治疗的初、复治的所有活动性肺结核患者为研究对象,通过结核病管理信息... 目的了解广州市番禺区活动性肺结核患者门诊费用构成,为制定和完善结核病控制策略、优化资源配置提供依据。方法以2016—2018年在番禺区慢性病防治站登记管理并完成治疗的初、复治的所有活动性肺结核患者为研究对象,通过结核病管理信息系统、HISS系统、患者病案收集活动性肺结核患者的人口学特征、治疗分类、痰检结果、医疗保障方式等基本信息,计数资料采用均数、中位数表示,组间比较采用秩和检验(Mann-Whitney U)。结果共纳入1 723 例活动性肺结核患者,平均年龄为(36±16)岁,其中男性1 163例,女性560例;本地患者718例,占41.67%,外地患者1 005例,占 58.33%。调查对象的门诊直接医疗费中位数为 1 737.50元,其中人均检查费、检验费、药费和其他费用的中位数分别为88.32、333.88、1 124.21和131.99元。经两样本秩和检验发现,菌阳和菌阴患者、不同病灶范围患者、有医疗保障患者和无医疗保障患者、医改前和医改后患者之间直接医疗费用的差异均存在统计学意义(P<0.05),以菌阳患者、单发病灶患者、有医疗保障患者、医改后患者治疗费用高。结论不同类型患者的治疗费用存在差异,应当针对不同类型的患者有所倾斜,并加大经费投入、完善医疗保障政策。 展开更多
关键词 活动性结核 费用 痰检 病灶
New debate of revascularization strategy of non-infarct-related artery lesions in patients with ST-segment elevation myocardial infarction and cardiogenic shock:decoding the CULPRIT-SHOCK trial,not enough to challenge the current guidelines
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作者 Fang Song Qiang Wu Xiao-Ping Chen 《中华医学杂志:英文版》 SCIE CAS CSCD 2019年第5期613-615,共3页
To the Editor: Research result of CULPRIT-SHOCK trial[1] presented at the Transcatheter Cardiovascular Therapeutics (TCT) 2017 conference suggested that acute myocardial infarction (AMI) patients with multivessel dise... To the Editor: Research result of CULPRIT-SHOCK trial[1] presented at the Transcatheter Cardiovascular Therapeutics (TCT) 2017 conference suggested that acute myocardial infarction (AMI) patients with multivessel disease (MVD) and cardiogenic shock undergoing primary percutaneous coronary interventions (PCI) treated with culprit-only revascularization (COR) strategy had lower mortality at one month compared with immediate complete revascularization in single procedure (CRS) strategy, which challenge current guidelines and years of consensus[2-5]. 展开更多
关键词 REVASCULARIZATION STRATEGY non-infarct-related artery LESIONS ST-SEGMENT elevation myocardial infarction
Ultrasound imaging of abdominal sarcoidosis: State of the art 预览
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作者 Claudio Tana Cosima Schiavone +6 位作者 Andrea Ticinesi Fabrizio Ricci Maria Adele Giamberardino Francesco Cipollone Mauro Silingardi Tiziana Meschi Christoph F Dietrich 《世界临床病例杂志》 2019年第7期809-818,共10页
Since it has been recognized that sarcoidosis (SA) is not an exclusive disorder of the lungs but can also affect other organs such as the liver and spleen, efforts have been made to define specific imaging criteria fo... Since it has been recognized that sarcoidosis (SA) is not an exclusive disorder of the lungs but can also affect other organs such as the liver and spleen, efforts have been made to define specific imaging criteria for the diagnosis of the single organ involvement, and the concept has been reinforced that the exclusion of alternative causes is important to achieve the correct diagnosis. Ultrasound (US) is a useful tool to evaluate patients with suspected abdominal SA, such as of the liver, spleen, kidney, pancreas and other organs, showing findings such as organomegaly, focal lesions and lymphadenopathy. While the diagnosis of abdominal SA is more predictable in the case of involvement of other organs (e.g., lungs), the problem is more complex in the case of isolated abdominal SA. The recent use of contrast-enhanced ultrasound and endoscopic ultrasound elastography has provided additional information about the enhancement patterns and tissue rigidity in abdominal SA. Here we critically review the role of US in abdominal SA, reporting typical findings and limitations of current evidence and by discussing future perspectives of study. 展开更多
关键词 SARCOIDOSIS SARCOID lesions GRANULOMATOUS disorders Liver SPLEEN Rare diseases ULTRASOUND CONTRAST-ENHANCED ULTRASOUND
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动脉期强化不明显肝脏占位性病变的CT表现及其在鉴别诊断中的意义 预览
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作者 冯晴 文明 《吉林大学学报:医学版》 CAS CSCD 北大核心 2019年第1期163-169,共7页
目的:研究在螺旋CT动态增强扫描中动脉期强化不明显肝脏占位性病变的CT表现,分析其特征并进行鉴别。方法:收集118例在CT增强扫描中动脉期强化不明显肝脏占位性病变患者的资料,分析比较其基本CT征象、特征性表现及强化方式。结果:118例... 目的:研究在螺旋CT动态增强扫描中动脉期强化不明显肝脏占位性病变的CT表现,分析其特征并进行鉴别。方法:收集118例在CT增强扫描中动脉期强化不明显肝脏占位性病变患者的资料,分析比较其基本CT征象、特征性表现及强化方式。结果:118例肝脏占位性病变患者中,肝转移瘤40例,肝脓肿29例,肝内胆管细胞癌21例,肝细胞癌17例,肝脏炎性假瘤6例,肝淋巴瘤5例;单发54例,多发64例;边缘清晰24例,边缘模糊94例;病变位于肝右叶41例,肝左叶26例,肝左右叶50例,肝尾状叶1例;病变直径0.2~13.4cm。40例肝转移瘤均呈边缘轻度强化,“牛眼征”出现率为12.50%(5/40);29例肝脓肿均呈环形、蜂窝样强化,“双环征”和“气泡征”出现率均为13.79%(4/29);17例肝内胆管细胞癌呈持续渐进强化,肝内胆管扩张、肝包膜凹陷和病灶内钙化出现率分别为57.14%(12/21)、23.81%(5/21)和9.52%(2/21);17例肝细胞癌强化方式多种多样,肝脏形态轮廓改变、肝动脉扭曲增粗和血管受侵出现率分别为41.18%(7/17)、41.18%(7/17)和35.29%(6/17);6例肝脏炎性假瘤中4例呈分隔以及结节样强化;5例肝淋巴瘤均呈轻度均匀强化,“血管漂浮征”出现率为40.00%(2/5)。结论:螺旋CT检查动脉期强化不明显肝脏占位性病变时,应结合CT征象及强化方式后进行综合判断,有助于为肝脏病变的定性及鉴别诊断提供重要依据。 展开更多
关键词 肝脏 占位性病变 电子计算机断层扫描 动态增强 鉴别诊断
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Hailey-Hailey disease with lichenoid lesions around the anus
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作者 Yi-Man Wang Yue-Ping Zeng +2 位作者 Wen-Ung Zhao Yue-Hua Liu Li Li 《中华医学杂志:英文版》 SCIE CAS CSCD 2019年第6期738-740,共3页
To the Editor: Hailey-Hailey disease (HHD), first discovered by the brothers Howard and Hugh Hailey,[1]is a genodermatosis at intertriginous sites. Mutation of ATP2C1 on chromosome 3q21-2 coding a calciumdependent ATP... To the Editor: Hailey-Hailey disease (HHD), first discovered by the brothers Howard and Hugh Hailey,[1]is a genodermatosis at intertriginous sites. Mutation of ATP2C1 on chromosome 3q21-2 coding a calciumdependent ATPase gives rise to calcium dysfunction within keratinocytes, resulting in acantholysis due to a signal transduction disorder.[2] It has been suggested that this gene mutation combined with irritation such as frequent friction, cold, and ultraviolet exposure leads to the development of HHD.[3] 展开更多
关键词 Hailey-Hailey DISEASE lichenoid LESIONS AROUND the ANUS
Biomarkers of intravenous immunoglobulin resistance and coronary artery lesions in Kawasaki disease
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作者 Wei-Xing Kong Fei-Yue Ma +4 位作者 Song-Ling Fu Wei Wang Chun-Hong Xie Yi-Ying Zhang Fang-Qi Gong 《世界儿科杂志(英文版)》 2019年第2期168-175,共8页
Background Currently,there are no reliable indicators for predicting intravenous immunoglobulin resistance and coronary artery lesions in the early stage of Kawasaki disease.Methods A total of 300 patients with Kawasa... Background Currently,there are no reliable indicators for predicting intravenous immunoglobulin resistance and coronary artery lesions in the early stage of Kawasaki disease.Methods A total of 300 patients with Kawasaki disease were studied retrospectively.Laboratory data were compared between the intravenous immunoglobulin resistant (29 patients) and responsive groups,and between the groups with coronary artery lesions (48 patients) and without coronary artery lesions.Results The intravenous immunoglobulin resistant group had significantly higher D-dimer,globulin,interleukin-6 and serum ferritin levels in comparison to the intravenous immunoglobulin responder group.D-dimer level had a sensitivity of 87.0% and a specificity of 56.3% for predicting intravenous immunoglobulin resistance at a cutoff point of 1.09 mg/L.Globulin had a sensitivity of 62.1% and a specificity of 82.3% for predicting intravenous immunoglobulin resistance at a cutoff point of 34.7 g/L.Serum ferritin level had a sensitivity of 42.9% and a specificity of 88.8% for predicting intravenous immunoglobulin resistance at a cutoff point of 269.7 ng/mL.The patients with coronary artery lesions had higher D-dimer and tumor necrosis factor-α level.D-dimer level had a sensitivity of 50% and a specificity of 78.6% for predicting coronary artery lesions at a cutoff point of 1.84 mg/L.Based on analysis by multivariate logistic regression,serum ferritin and globulin were independent risks for intravenous immunoglobulin resistance,D-dimer was independent risk for coronary artery lesions.Conclusions Elevated serum ferritin,globulin and D-dimer levels are significantly associated with intravenous immunoglobulin resistance in Kawasaki disease.Moreover,serum D-dimer is significantly increased in Kawasaki disease with coronary artery lesions. 展开更多
关键词 Biomarkers CORONARY artery LESIONS INTRAVENOUS IMMUNOGLOBULIN RESISTANCE KAWASAKI disease
CT冠脉血管成像技术诊断心绞痛患者的临床价值 预览
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作者 吴方辉 《中国当代医药》 2019年第10期35-38,共4页
目的评价CT冠脉血管成像技术诊断心绞痛患者的临床价值。方法选取2017年2月~2018年2月本院收治的107例疑似心绞痛患者,所有患者均实施CT冠脉血管成像技术诊断及冠状动脉造影诊断,并以冠状动脉造影作为金标准,分析CT冠脉血管成像技术在... 目的评价CT冠脉血管成像技术诊断心绞痛患者的临床价值。方法选取2017年2月~2018年2月本院收治的107例疑似心绞痛患者,所有患者均实施CT冠脉血管成像技术诊断及冠状动脉造影诊断,并以冠状动脉造影作为金标准,分析CT冠脉血管成像技术在心绞痛诊断中的准确度、灵敏度、特异度。结果107例疑似患者经冠状动脉造影确诊为心绞痛者88例,非心绞痛者19例;其中88例心绞痛中包括重度狭窄32例,中度狭窄35例,轻度狭窄21例。107例疑似患者经CT冠脉血管成像技术确诊为心绞痛者85例,非心绞痛者22例;其中85例心绞痛中包括重度狭窄30例,中度狭窄34例,轻度狭窄21例。CT冠脉血管成像技术诊断检出率为79.4%(85/107),诊断符合率为96.59%(85/88)。CT冠脉血管成像技术诊断符合率与金标准比较,差异无统计学意义(P>0.05)。CT冠脉血管成像技术诊断灵敏度为100.00%,特异度为86.36%。结论在心绞痛诊断中,应用CT冠脉血管成像技术可有效鉴别心绞痛病变情况,为临床诊治提供有效的参考依据,且其属于无创检查,检查方便、简单、安全,受到医生及患者的普遍认可,可作为心绞痛最常用的一种诊断手段,值得临床推广应用。 展开更多
关键词 CT冠脉血管成像技术 冠状动脉造影 心绞痛 病变情况 诊断符合率
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Molar incisor hypomineralization and pre-eruptive intracoronal lesions in dentistry-diagnosis and treatment planning 预览
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作者 Uri Zilberman Jomanna Hassan Shirley Leiboviz-Haviv 《世界口腔医学杂志》 2019年第2期20-27,共8页
The aim of this study is to report the diagnostic features,prevalence,mineral content,clinical significance and treatment options of molar incisor hypomineralization (MIH) and pre-eruptive intracoronal lesions (PEIR),... The aim of this study is to report the diagnostic features,prevalence,mineral content,clinical significance and treatment options of molar incisor hypomineralization (MIH) and pre-eruptive intracoronal lesions (PEIR),in order to minimize miss-treatment of primary and permanent teeth in young children.MIH was defined as the occurrence of hypomineralization of one up to four permanent first molars from a systemic origin and frequently associated with affected incisors.PEIR are lesions that are located in the occlusal portion of the crown of unerupted permanent or primary teeth.The prevalence of MIH was reported between 2.5%-40% in the permanent first molars and 0%-21.8% in primary second molars.PEIR was observed in 2%-8% of children,mainly in mandibular second premolars and second and third permanent molars.A number of possible causes for MIH were mentioned,including environmental changes,diet and genetics in prenatal and postnatal periods,but all are questionable.In PEIR,the resorption of the intracoronal dentine begins only after crown development is complete and is caused by giant cells resembling osteoclast observed histologically on the dentine surface close to the pulp.The mineral content in MIH is reduced in comparison to normal enamel and dependent on the severity of the lesion.In PEIR the resorbed surface of enamel showed less mineral content.The hypomineralized enamel in MIH is not suitable for restorations with amalgam or composite materials,and the best material should be based on remineralization material like glass-ionomers.Similar,the resorbed dentin surface in PEIR should be covered by the biocompatible and remineralizing glass-ionomer cement. 展开更多
关键词 MOLAR INCISOR hypomineralization Pre-eruptive intracoronal LESIONS Glassionomer cements Enamel DENTIN
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