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如何合理应用超声心动图新技术进行临床诊断和研究
由于计算机技术的快速发展,推动了超声心动图技术的不断进步,近年来,不断涌现的超声心动图新技术包括组织多普勒成像(tissue doppler imaging,TDI)及其相关技术;二维应变超声心动图(two-dimensional strain imaging,2DSI);自动功能成像(automatic function imaging,AFI);速度向量成像(velocity vector imaging,VVI);超声瞬时波强(wave intensity,WI);超声向量血流成像(vector flow mapping,VFM);心肌对比超声心动图(myocardial contrast echo,MCE);心脏二维血流成像技术(cardiac B-flow imaging,CBFI);四维容积成像(four dimensional volume imaging);三维斑点追踪成像(three dimensional spackle tracking imaging,3DSTI)等.
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聚合酶链反应临床应用的优越性和局限性
聚合酶链反应(PCR)技术自1983年问世以来,因其对基因或特定核酸序列在短时间内具有极大的扩增效率,已广泛应用于感染性疾病、肿瘤、遗传病、寄生虫病、法医学、动植物和考古等诊断和研究领域,并在某些方面呈现出几乎难以替代的优势.PCR用于疾病的临床诊断后,使人们对蛋白分子表型的认识,进一步深入到了遗传物质--核酸分子的探索,也使临床检验诊断学科中的临床分子诊断技术得到了飞速发展.像任何自然界的事物一样,PCR虽然有其无可比拟的优点,但也有其一定的局限性.如果在临床实际应用中,不遵循客观规则,也很容易产生非PCR技术问题所致的错误检验结果.
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电流型免疫传感器在临床诊断中的应用
近年来,基于抗原抗体反应的电化学免疫传感器作为一种新兴的生物传感器,以其鉴定物质的高度特异度、敏感度和稳定性在诸多领域得到广泛应用,如:食品工业、环境监测、生物工程、化学制药和临床诊断~([1-2]).
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临床前肥厚型心肌病的临床表现谱:肌小节基因突变携带者的特征
肥厚型心肌病(HCM)主要为肌小节突变所致,其临床表现差异很大,合并一系列严重后果,如猝死、终末期心力衰竭.通常因心脏影像发现无法解释的左心窜肥厚而确诊,但这一特征与年龄高度相关,儿童期多无心脏肥厚形态学表现,故目前临床往往在青春期或青春期后才能作出HCM的诊断.
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老年期痴呆临床诊断和鉴别诊断的思路与步骤
一、痴呆的定义美国精神障碍诊断和统计手册第四版(DSM-Ⅳ)[1]关于痴呆的定义为多种认知功能缺陷,包括记忆损害和(或)至少以下认知障碍的一种:失语、失用、失认或执行功能障碍.认知损害足以严重到引起职业或社会功能的损害,并且与以往的高认知水平相比有所下降.而这些均不发生在谵妄中.中外专家均赞同以上定义,认为痴呆是器质性疾病引起的一组获得性、持续性的多种严重认知功能衰退的临床综合征.
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牙体牙髓临床问题解析Ⅴ.根尖周炎临床诊断和预后与组织病理学表现的相关性(一)
根尖周炎是指发生于根尖周围组织(包括根尖部的牙骨质、牙周膜和牙槽骨)的炎症性疾病,主要由存在于牙齿根管系统中的细菌及其毒性产物通过根尖孔作用于根尖周组织引发,是宿主在感染刺激物入侵的前沿部位所表现出的防御反应.
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经颅三维多普勒技术对脑震诊断、疗效及愈后的评估
Objective In order to offer a noninvasive and objective examination method for assessing the clinical diagnosis and eurative criterion of concussion patients, the patients color three - dimensional transcranial doppler( 3D - TCD) characteristic at deferent phases, parameter and clincal manifestation were studied Method Parameter of Median Cerebral Artery(MCA), Base Artery(BA), the average peak forwand velocity of cerebral blood flow, train figure were tested by 3D - TCD within 24 hours, 3 - 6 days and at the end of treatment, respectively. The results were compared with clinical diagnoses and curative criterion. Result Among 135 patients who had clinically diagnosed concussion, agreeable diagnoses 101 cases, basically agreeable diagnooses 12 cases, disagreeable diagnosis 22 cases(16. 2%) .At the end of treatment, according to clinical determination 96 cases(71.1%) were cured, 39 cases(28.9%) were improved. Wave train character, figure and diagnoses prameter of cerebral spasm caused by concussion were suggested Conclusion To be one of the diagnostic bases and curative criterion, 3D- TC D technology is performable. Meanwhile, it is a new testing objective technique for assessing curative and determining prognosis.
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平板运动试验在临床的应用
1 概述平板运动试验是各种负荷试验中重要的一种(负荷试验:包括平板运动试验,踏车运动,双倍二极梯和心房调搏试验).
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共聚焦激光扫描显微镜在皮肤浅部真菌感染诊断中应用价值的评估
目的 探讨皮肤共聚焦激光扫描显微镜(CLSM)在常见浅部真菌感染诊断中的应用价值.方法 根据临床病史及体征初步诊断为浅部真菌感染患者59例,选定3处典型皮损做CLSM检查,记录各项指标的扫描结果,再行真菌镜检.结果 CLSM检测的25例手足癣患者中,14例(56%)角质层内可见菌丝,真菌镜检均阳性;11例角质层内未发现菌丝,真菌镜检8例阳性;新皮损(<3周)共8例,CLSM阳性 7例,真菌镜检均阳性;旧皮损(>3周)共17例,CLSM阳性7例(41%),真菌镜检阳性14例(82%).在检测的24例股癣患者中,19例(79.17%)角质层内可见菌丝,真菌镜检均阳性;5例角质层内未发现菌丝,真菌镜检4例阳性;新皮损(<3周)共17例,CLSM阳性16例(94.12%),真菌镜检均阳性;旧皮损(>3周)共7例,CLSM阳性3例,真菌镜检阳性6例.在检测的10例花斑糠疹患者中,CLSM均未发现菌丝,而真菌镜检阳性8例.外用联苯苄唑乳膏2周后的10例手足癣、股癣患者,CLSM检查均未见菌丝,角质层完整,真菌镜检阴性.结论 CLSM在手足癣、股癣的新发皮损的检查上与真菌镜检具有较高的一致性,在临床诊断上有一定的应用价值.
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儿童膝关节镜检查(附23例临床报告)
本文报告23例(24个膝关节)儿童膝关节镜检查资料.儿童膝关节镜检查诊断符合率可达90%以上,而一般临床诊断符合率仅45.8%.镜检既可在直视下观察整个关节腔静态及动态变化,也能同时施行镜下活检和切除病损滑膜、关节软骨及半月软骨等手术.因此,膝关节镜检是一种准确有效、安全可靠的诊断治疗手段.
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急性原发性闭角型青光眼
Acute primary closed angle glaucoma is fast becoming one of the most important causes of blindness in the 21 st Century. World bhnding statistics show that there are 60 million people suffering from glaucoma. Of these,approximately 6 million are blind and 1.5 million (25%) are due to acute closed angle glaucoma. With the aging population, the number of patients blind from glaucoma will continue to increase.Attacks from acute primary closed angle glaucoma can lead to irreversible blindness to the affected eye.Blindness can be effectively prevented in acute primary closed angle glaucoma because the severity of symptoms will draw the attention of the patient who will then seek for medical care. Therefore, it is essential to educate the public,doctors and healthcare workers about the danger and symptoms of acute glaucoma. With early diagnosis and treatment to the affected eye and laser iridotomy to the fellow eye-bilateral blindness from acute glaucoma can be prevented.This paper highlights important clinical advances in the management of acute primary closed angle glaucoma and also poses several questions for discussion.(1) What evidence is there to suggest that bilateral blindness from acute primary closed angle glaucom is preventable?(2) In what way is Ultrasonic Biomicroscopy (UBM) useful in clinical research in glaucoma?(3) Will UBM be important in clinical diagnosis in primary closed angle glaucoma?(4) What is the scientific basis of treatment in acute primary closed angle glaucoma?(5) What are the essential procedures to preserve vision in chronic primary closed angle glaucoma?(6) What are the reasons for blindness after laser iridotomy?(7) What is the mechanism of laser iridoplasty?(8) What are the reasons why laser iridoplasty should be combined with laser iridotomy?(9) Why there is an intraocular pressure increase in 50% of eyes within 3 months after laser iridoplasty?(10) Can UBM explain the changes in the angle after lens removal in primary closed angle glaucoma?(11) Are there reasons why trabeculectomy is infrequently used in acute glaucoma, yet it is an important procedure in chronic primary closed angle glaucoma?(12) The scientific reasons why laser iridotomy is essential in the fellow eye.