• 【持续性哀伤和重度抑郁症的症状: 绝症癌症患者家庭照顾者丧亲的前2年的独特性和时间关系。】 复制标题 收藏 收藏
    DOI:10.1002/pon.5333 复制DOI
    作者列表:Tsai WI,Wen FH,Kuo SC,Prigerson HG,Chou WC,Shen WC,Tang ST
    BACKGROUND & AIMS: OBJECTIVE:Prolonged grief disorder (PGD) and major depressive disorder (MDD) are common syndromes shaping bereaved caregivers' quality of life (QOL). However, distinctiveness of these syndromes warrants confirmation, and the temporal relationship of PGD and MDD symptoms has not been established. To fill these knowledge gaps, we conducted this longitudinal study. METHODS:PGD symptoms, depressive symptoms, and psychological QOL were measured over 398 caregivers' first 2 years of bereavement using the Prolonged Grief-13 (PG-13) scale, Center for Epidemiologic Studies-Depression (CES-D) scale, and Short Form-36 Health Survey mental health summary, respectively. To clarify the distinctiveness of PGD and MDD symptoms, we examined their associations with psychological QOL by incremental validity testing. Distinctiveness and temporal relationship of PGD and MDD symptoms were also examined using longitudinal, lower-level mediation analysis with a lagged approach. RESULTS:After the variance in psychological QOL was explained by CES-D scores (pseudo-R2 = 44.19%, P < .001), PG-13 scores significantly, incrementally increased the explained variance in psychological QOL (pseudo-R2 = 0.21%, P < .001), confirming the distinctiveness of PGD and MDD symptoms. CES-D scores mediated 40.7% of the time vs PG-13 score relationship, whereas PG-13 scores mediated 78.2% of the time vs CES-D score relationship with a better model fit, indicating that PG-13 scores assessed earlier mediated caregivers' current depressive status rather than vice versa. CONCLUSIONS:PGD and MDD are distinct constructs, and PGD precedes onset of MDD. Clinicians should distinguish between these two disorders and address bereaved caregivers' PGD to reduce PGD-associated distress and morbidity and to prevent MDD onset, thereby improving their QOL.
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  • 【[克罗恩病并发多发性和复发性无菌性脾脓肿]。】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Coat N,Le Berre-Heresbach N,Poinsignon Y,Rioux-Leclercq N,Turlin B,Siproudhis L,Caulet-Maugendre S,Bretagne JF,Gosselin M,Heresbach D
    BACKGROUND & AIMS: :We report a case of multiple aseptic splenic abscesses occurring in a woman with Crohn's disease for three years. All microbiological samples were negative. The diagnosis was suspected on abdominal echography and CT scan and confirmed on histologic examination of the splenectomy specimen. The evolution was marked by recurrence of fever and inflammatory syndrome, associated to transitory morphological abnormalities of the accessory spleen. Aseptic splenic abscesses recurrence was suspected. This case allows us to consider aseptic splenic abscesses as an extra-intestinal manifestation and not as a splenic localisation of Crohn's disease.
    背景与目标: : 我们报告了一名患有克罗恩氏病的妇女三年发生的多发性无菌性脾脓肿的病例。所有微生物样本均为阴性。在腹部回声造影和ct扫描中怀疑诊断,并在脾切除术标本的组织学检查中证实。这种演变的特征是发热和炎症综合征的复发,与副脾的暂时性形态异常有关。怀疑无菌性脾脓肿复发。这种情况使我们能够将无菌性脾脓肿视为肠外表现,而不是克罗恩氏病的脾脏定位。
  • 【推测感染性脑膜脑炎并发双侧视神经炎。】 复制标题 收藏 收藏
    DOI:10.1177/112067210701700531 复制DOI
    作者列表:Gore DM,Hildebrand GD,Sekhri R,Nicolaides P,Leitch J
    BACKGROUND & AIMS: PURPOSE:To report a case of presumed infective meningoencephalitis complicated by bilateral optic neuritis. METHODS:Interventional case report. RESULTS:A 7-year-old Pakistani girl presented with fever and multiple right-sided focal seizures. Despite empirical treatment with antibiotic, anti-viral and anti-tuberculous therapy for presumed infective meningoencephalitis, she further deteriorated, developing altered consciousness, hemiplegia and severe, bilateral optic neuritis. No infectious agent could be identified. Following the addition of high dose systemic corticosteroid therapy, her optic nerve function in both eyes began to recover. At 3-month follow-up, the hemiplegia had completely resolved, and visual acuity was 6/6 bilaterally with normal pupillary responses. CONCLUSIONS:This case demonstrates that meningoencephalitis of presumed infective origin may be complicated by acute, severe, bilateral optic neuritis, the latter often mediating profound visual loss. In the setting of rapidly deteriorating vision, aggressive corticosteroid treatment, with antimicrobial cover, albeit unproven, remains the mainstay of treatment.
    背景与目标:
  • 【原发性干燥综合征并发非霍奇金淋巴瘤一例报告并文献复习。】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Panchovska M,Petranova T,Sheitanov Y,Stoilov R,Kolarov R,Bobeva D
    BACKGROUND & AIMS: :Primary Sjögren's syndrome (PSS) is an autoimmune disease of the exocrine glands that is presented with progressive ocular and oral dryness, parotid enlargement and often with systemic (extraglandular) manifestations. In patients with PSS the risk of development of non-Hodgkin's lymphoma (NHL) is 44-fold compared to healthy population. The risk is associated with certain characteristics of the disease's course: recurrent changes in the parotid glands, lymph node enlargement, skin vasculitis, peripheral neuropathy, anemia and lymphopenia. According to the morphologic and phenotypic characteristics, B-cell low-grade lymphomas prevail. This communication presents a 65-year-old woman with PSS who developed a follicular type B-cell NHL 21 years after the autoimmune disease had been diagnosed. The analysis of our case and the literature review summarize the characteristics of the course of PSS, histologic variants, and evolution and prognosis of NHL in this kind of patients.
    背景与目标: : 原发性干燥综合征 (PSS) 是外分泌腺的一种自身免疫性疾病,表现为进行性眼和口腔干燥,腮腺肿大,通常具有全身 (腺外) 表现。与健康人群相比,PSS患者发生非霍奇金淋巴瘤 (NHL) 的风险是44倍。风险与疾病过程的某些特征有关: 腮腺的反复变化,淋巴结肿大,皮肤血管炎,周围神经病变,贫血和淋巴细胞减少。根据形态学和表型特征,以b细胞低度淋巴瘤为主。本通讯介绍了一名65岁的PSS妇女,该妇女在诊断出自身免疫性疾病21年后发展为滤泡型b细胞NHL。本例的分析和文献综述总结了此类患者PSS的病程特征,组织学变异以及NHL的演变和预后。
  • 【应对损失: 绘制表达悲伤的数字仪式。】 复制标题 收藏 收藏
    DOI:10.1080/10410236.2016.1242038 复制DOI
    作者列表:Gamba F
    BACKGROUND & AIMS: :Although death has been frequently discussed in health communication, there has been a lack of research on coping with loss. Nevertheless, there are many websites and social network sites that offer suggestions to people as to how to cope with loss, including sites for support, sharing of experiences, and expressing grief. This article provides a theoretical understanding of grief by considering it as an emotional experience in terms of how it is expressed, its consequences, and the confrontation between the offline and online grief experience.
    背景与目标: : 尽管在健康交流中经常讨论死亡,但缺乏应对损失的研究。然而,有许多网站和社交网站向人们提供如何应对损失的建议,包括支持、分享经验和表达悲伤的网站。本文通过将悲伤视为一种情感体验,从表达方式,后果以及离线和在线悲伤体验之间的对抗来提供对悲伤的理论理解。
  • 【患有 “右侧” Hirschsprung病并伴有难治性高血压和咳嗽的成年女性的再次手术。】 复制标题 收藏 收藏
    DOI:10.3748/wjg.v22.i41.9235 复制DOI
    作者列表:Wei ZJ,Huang L,Xu AM
    BACKGROUND & AIMS: :Hirschsprung's disease (HD) is an intestinal malformation caused by the innate absence of ganglion cells in the neural plexus of the colorectal wall, and is most common in male infants. It is rare in adult, and is usually left-sided. Herein we reported based on the CARE guidelines a case of a 47-year-old adult female suffering from "right-sided" HD complicated by refractory hypertension and cough. The patient with a history of cesarean section and with digestive unfitness (abdominal pain, distention, and constipation) only since 20 years old had recurrence of HD after initial surgery due to the incomplete removal of the HD-affected bowel based on a diagnosis of "chronic ileus", leading to the relapse of the digestive symptoms and the emergence of some intractable circulatory and respiratory complications which could be hardly controlled by conservative treatment. During the long interval before coming to our department for help, she had been re-hospitalized for several times with various misdiagnoses and supplied merely with symptomatic treatment which could only achieve temporary symptomatic relief. At her admission to our department, the imaging examinations strongly indicated recurrent HD which was further supported by pathological examinations, and right hemi-colectomy was performed to remove the remnant aganglionic intestinal segment. Intraoperative and postoperative pathology supported the completeness of the definitive resection. Post-operation, the patient's bowel motility significantly improved, and interestingly, the complications disappeared. For adult patients with long-term constipation combined with cough and hypertension, rare diseases like HD which requires definite surgery and which could be "right-sided" should not be overlooked. It is vital to diagnose and cure HD patients in childhood. Through the comparison of the two surgeries, it is noteworthy that for diagnosed HD, sufficient removal of the non-functional intestine confirmed by intraoperative pathology is essential.
    背景与目标: : Hirschsprung病 (HD) 是由于结肠直肠壁神经丛中神经节细胞先天缺失而引起的肠道畸形,最常见于男婴。在成人中很少见,通常为左侧。在此,我们根据护理指南报告了一例47岁的成年女性患有 “右侧” HD并伴有难治性高血压和咳嗽的病例。自20岁起才有剖宫产史且消化功能不健康 (腹痛,扩张和便秘) 的患者,由于诊断为 “慢性肠梗阻”,HD受影响的肠道未完全切除,因此在初次手术后复发了HD。导致消化系统症状复发,并出现一些顽固性循环和呼吸系统并发症,保守治疗难以控制。在来我们部门寻求帮助之前的很长一段时间内,她因各种误诊而再次住院了几次,仅提供对症治疗,只能暂时缓解症状。在她入院时,影像学检查强烈提示复发性HD,并得到病理检查的进一步支持,并进行了右半结肠切除术以去除残留的神经节肠段。术中和术后病理支持确定性切除的完整性。术后,患者的肠蠕动明显改善,有趣的是,并发症消失了。对于长期便秘合并咳嗽和高血压的成人患者,HD等罕见疾病需要明确手术且可能 “右侧” 的疾病不容忽视。诊断和治疗儿童时期的HD患者至关重要。通过两种手术的比较,值得注意的是,对于确诊的HD,术中病理证实的无功能肠的充分切除至关重要。
  • 【慢性心力衰竭并发严重三尖瓣反流的患者一年全因死亡率的超声心动图决定因素。】 复制标题 收藏 收藏
    DOI:10.1016/j.cardfail.2016.11.005 复制DOI
    作者列表:Hu K,Liu D,Störk S,Herrmann S,Oder D,Ertl G,Voelker W,Weidemann F,Nordbeck P
    BACKGROUND & AIMS: BACKGROUND:Right ventricular (RV) dysfunction plays an important role in chronic heart failure (CHF). We evaluated the echocardiographic determinants of 1-year all-cause mortality in CHF patients with clinically relevant functional tricuspid regurgitation (TR). METHODS AND RESULTS:A total of 101 consecutive CHF patients (mean age 74 ± 10 years, 53% male) with moderate or severe functional TR were enrolled. Each patient underwent at least 2 echocardiography examinations in an interval of >6 months. Clinical follow-up was made after a median of 305 (interquartile range 164-365) days after the last echocardiography. The primary end point was all-cause mortality. Forty-two patients (42%) died during follow-up. Baseline right atrial (RA) area, TR volume increase and RV enlargement over time were significantly higher in nonsurvivors than survivors (all P < .05). Compared to baseline levels, systolic pulmonary artery pressure (sPAP) was significantly reduced in nonsurvivors during follow-up echocardiography (54 ± 19 vs 49 ± 21 mm Hg; P = .010), but significantly increased in survivors (48 ± 17 vs 54 ± 17 mm Hg; P = .001). Multivariable survival analysis suggested that baseline RA area ≥27 cm2 (hazard ratio [HR] 2.41, 95% confidence interval [CI] 1.21-4.80; P = .013), follow-up TR proximal isovelocity surface area regurgitant volume increase ≥15 mL (HR 2.27, 95% CI 1.20-4.31; P = .012), RV middle diameter increase ≥10 mm (HR 2.38, 95% CI 1.10-5.11; P = .027), and sPAP reduction ≥10 mm Hg (HR 3.04, 95% CI 1.51-6.13; P = .002) were determinants of 1-year all-cause mortality after the last echocardiography. Patients with 2 or 3 of these determinants were faced with significantly increased 1-year mortality (88% or 100%). CONCLUSIONS:Dynamic RV morphologic and functional changes during serial echocardiography are associated with significantly increased mortality risk in CHF patients with moderate or severe functional TR.
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  • 【达托霉素与万古霉素治疗复杂皮肤和皮肤结构感染: 临床和经济结果。】 复制标题 收藏 收藏
    DOI:10.1592/phco.27.12.1611 复制DOI
    作者列表:Davis SL,McKinnon PS,Hall LM,Delgado G Jr,Rose W,Wilson RF,Rybak MJ
    BACKGROUND & AIMS: STUDY OBJECTIVE:To assess the effect of daptomycin compared with vancomycin on the clinical and economic outcomes in patients with complicated skin and skin structure infections. DESIGN:Prospective, open-label study. SETTING:Level 1 trauma center in Detroit, Michigan. PATIENTS:Fifty-three adult patients with complicated skin and skin structure infections at risk for methicillin-resistant Staphylococcus aureus (MRSA) infection who were treated with daptomycin and a matched cohort of 212 patients treated with vancomycin. INTERVENTION:Patients in the prospective arm received intravenous daptomycin 4 mg/kg every 24 hours for at least 3 days but not more than 14 days. Historical controls received at least 3 days of vancomycin dosed to achieve trough concentrations of 5-20 microg/ml. MEASUREMENTS AND MAIN RESULTS:Outcomes evaluated included blinded assessments of clinical resolution, duration of therapy, and costs. The most common diagnoses were cellulitis (31%), abscess (22%), and both cellulitis with abscess (37%). Microbiology differed significantly between groups, with S. aureus found in 27 patients (51%) in the daptomycin group and 167 patients (79%) in the vancomycin group and MRSA in 22 (42%) and 159 (75%), respectively (p<0.001). The proportions of patients with clinical improvement or resolution of their infections on days 3 and 5 were 90% versus 70% and 98% versus 81% in the daptomycin versus vancomycin groups, respectively (p<0.01 for both comparisons), and 100% at the end of therapy in both groups. Among patients with complete resolution of their infections (41 patients [77%] with daptomycin vs 89 patients [42%] with vancomycin, p<0.05), median duration of intravenous therapy was 4 and 7 days, respectively, (p<0.001), and hospital costs were $5027 and $7552 (p<0.001). CONCLUSIONS:Patients receiving daptomycin achieved more rapid resolution of symptoms and clinical cure and had a decreased duration of inpatient therapy compared with those receiving vancomycin. This study suggests that daptomycin is a cost-effective alternative to vancomycin for complicated skin and skin structure infections.
    背景与目标:
  • 9 Complicated elbow fractures in athletes. 复制标题 收藏 收藏

    【运动员的复杂肘部骨折。】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Hurley JA
    BACKGROUND & AIMS: :The elbow is a key link in the function of the upper extremity and therefore, is subject to various stresses and strains. These stresses may be in the form of a single macrotrauma or repetitive microtrauma with each having its effect on the architecture of the elbow. In dealing with athletes with elbow disorders, one is faced with the challenge of maintaining mobility while achieving maximal stability. Therefore, what has been proposed are treatment formulas for some of the more common elbow fractures that affect the athletic population, which the author has found to be quite useful in achieving these goals.
    背景与目标: : 肘部是上肢功能的关键环节,因此承受各种应力和应变。这些应力可以是单个宏观创伤或重复性微创伤的形式,每种应力都对肘部的结构产生影响。在与患有肘部疾病的运动员打交道时,人们面临着在保持运动能力的同时实现最大稳定性的挑战。因此,已经提出了一些影响运动人群的较常见的肘部骨折的治疗公式,作者发现这对于实现这些目标非常有用。
  • 【结直肠手术后复杂的腹腔内收集的管理 (COMPASS): 一项多中心,观察性,前瞻性国际结直肠手术引流做法研究的方案。】 复制标题 收藏 收藏
    DOI:10.1111/codi.15275 复制DOI
    作者列表:EuroSurg Collaborative.
    BACKGROUND & AIMS: AIM:Postoperative drains have historically been used for the prevention and early detection of intra-abdominal collections. However, current evidence suggests that prophylactic drain placement following colorectal surgery has no significant clinical benefit. This is reflected in the enhanced recovery after surgery (ERAS) guidelines, which recommend against their routine use. The Ileus Management International study found more than one-third of participating centres across the world routinely used drains in the majority of colorectal resections. The aim of the present study is to audit international compliance with ERAS guidelines regarding the use of postoperative drains in colorectal surgery. METHOD:This prospective, multicentre audit will be conducted via the student- and trainee-led EuroSurg Collaborative network across Europe, South Africa and Australasia. Data will be collected on consecutive patients undergoing elective and emergency colorectal surgery with 30-day follow-up. This will include any colorectal resection, formation of colostomy/ileostomy and reversal of stoma. The primary end-point will be adherence to ERAS guidelines for intra-abdominal drain placement. Secondary outcomes will include the following: time to diagnosis of intra-abdominal postoperative collections; output and time to removal of drains; and 30-day postoperative complications defined by the Clavien-Dindo classification. CONCLUSION:This protocol describes the methodology for the first international audit of intra-abdominal drain placement after colorectal surgery. The study will be conducted across a large collaborative network with quality assurance and data validation strategies. This will provide a clear understanding of current practice and novel evidence regarding the efficacy and safety of intra-abdominal drain placement in colorectal surgical patients.
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  • 【鼻窦炎并发硬脑膜窦血栓形成和肺炎链球菌心内膜炎: 一例病例报告并文献复习。】 复制标题 收藏 收藏
    DOI:10.1016/j.jinf.2007.02.011 复制DOI
    作者列表:Booker J,Musher D
    BACKGROUND & AIMS: :Streptococcus pneumoniae endocarditis is most commonly associated with pneumonia. It is relatively uncommon disease but its severity makes it clinically relevant. We present a case and review of sinusitis complicated by both pneumococcal endocarditis and cavernous sinus thrombosis. Both endocarditis and dural sinus thrombosis are known complications of facial infections. To our knowledge, this is the first reported case of both S. pneumoniae endocarditis and dural sinus thrombosis complicating sinusitis. A case report and review of the literature is presented.
    背景与目标: : 肺炎链球菌和心内膜炎是最常见的肺炎。这是相对罕见的疾病,但其严重程度使其具有临床相关性。我们介绍了一例并回顾了并发肺炎球菌性心内膜炎和海绵窦血栓形成的鼻窦炎。心内膜炎和硬脑膜窦血栓形成都是面部感染的已知并发症。据我们所知,这是第一例报道的肺炎链球菌心内膜炎和硬脑膜窦血栓形成并发鼻窦炎的病例。提出了病例报告和文献综述。
  • 【复杂性小儿输尿管重复的单阶段手术方法: 手术和功能结果。】 复制标题 收藏 收藏
    DOI:10.1007/s00383-013-3411-8 复制DOI
    作者列表:Ellerkamp V,Szavay P,Luithle T,Schäfer JF,Amon O,Fuchs J
    BACKGROUND & AIMS: PURPOSE:Surgical approach to children with complicated ureteral duplication is discussed controversially. Our aim was to determine the outcome of children with complicated renal duplication undergoing a single-stage surgical approach with laparoscopic partial nephrectomy and open bladder reconstruction. METHODS:Data of patients from 2004 to 2008 were investigated retrospectively. Outcome was analyzed in terms of postoperative course, renal function, urinary tract infection and functional voiding. RESULTS:Thirteen patients were treated with laparoscopic partial nephrectomy and reconstruction of the lower urinary tract in a single-stage approach. Median age at operation was 15 months (2-63 m). One girl had a renal triplication. 7/13 patients presented with an ectopic ureterocele, two with an ectopic ureter, severe vesicoureteral reflux occurred in 6 patients. All patients had non-functioning renal moieties. Mean operative time was 239 min (129-309; SD 50). One re-operation was necessary 4 years after primary surgery due to a pole remnant. All patients had uneventful recoveries without evidence of recurrent UTI. Postoperative 99mTc-MAG3 scans showed no significant reduction of partial renal function (p = 0.4), and no signs of obstruction (p = 0.188). During a median follow-up of 60 months (49-86), dysfunctional voiding occurred in one patient. CONCLUSIONS:In children with complicated ureteral duplication a definitive single-stage procedure is feasible and shows excellent functional results.
    背景与目标:
  • 【损失整合在解离与持续性哀伤紊乱关系中的中介作用。】 复制标题 收藏 收藏
    DOI:10.1002/jclp.22479 复制DOI
    作者列表:Hasson-Ohayon I,Peri T,Rotschild I,Tuval-Mashiach R
    BACKGROUND & AIMS: OBJECTIVE:Findings from the field of trauma have shown that there is a negative relationship between dissociation and integration of loss into the self-narrative. At the same time, an increasing amount of literature on grief has stressed the importance of an integrated self-narrative in the grieving process. Accordingly, the current study examined the possible mediating role played by the extent to which individuals have integrated their loss into their self-narrative in the relationship between dissociation and symptoms of prolonged grief disorder (PGD). METHOD:The Prolonged Grief Disorder Scale (PGD-13), the Outcome Questionnaire, the Integration of Stressful Life Experiences Scale, the Dissociative Experiences Scale, and a sociodemographic questionnaire were administered to 66 individuals who had lost a loved one. RESULTS:The hypothesized mediation model of integration was confirmed. CONCLUSION:The effect of people's dissociative tendencies on their PGD symptoms seems to occur via the impairment of their ability to integrate the memory of their loss into their general autobiographical memory. Empirical and clinical implications are discussed.
    背景与目标:
  • 【妊娠合并妊娠糖尿病剖宫产后分娩试验。】 复制标题 收藏 收藏
    DOI:10.1002/ijgo.12164 复制DOI
    作者列表:Ganer Herman H,Kogan Z,Bar J,Kovo M
    BACKGROUND & AIMS: OBJECTIVE:To assess rates of, and factors associated with, trial of labor and vaginal delivery among pregnancies complicated by both gestational diabetes (GDM) and a previous cesarean delivery. METHODS:In a retrospective study of singleton deliveries at a university hospital in Israel between 2009 and 2015, women with one previous cesarean delivery and GDM were matched to those without GDM by past cesarean delivery indication: non-favorable (non-progressive labor or failed induction) or favorable (all other indications). Computerized files were reviewed, and maternal, obstetric, and neonatal outcomes were compared. RESULTS:In total, 109 women with GDM were matched to 109 control women. Trial of labor was attempted by 55 (50.5%) women in the control group and 11 (10.1%) in the GDM group (P<0.001). Overall, 42 (38.5%) control women and 5 (4.6%) women with GDM delivered vaginally (P<0.001). Multivariable logistic regression identified lack of GDM as the most significant factor associated with trial of vaginal delivery, followed by a prior vaginal delivery. Among women attempting a trial of labor, past vaginal delivery, but not GDM status, was associated with successful vaginal delivery. CONCLUSION:GDM significantly diminished the likelihood of a trial of vaginal delivery after cesarean delivery and its subsequent success.
    背景与目标:
  • 【妊娠合并I型糖尿病的子宫弓形动脉多普勒和蜕膜微血管病理。】 复制标题 收藏 收藏
    DOI:10.1046/j.1469-0705.1996.08020098.x 复制DOI
    作者列表:Barth WH Jr,Genest DR,Riley LE,Frigoletto FD Jr,Benacerraf BR,Greene MF
    BACKGROUND & AIMS: The objective was to correlate Doppler indices from the uterine arcuate arteries with an analysis of the decidual vascular histology in patients with type I diabetes. Pulsed wave Doppler was used to sample the uterine arcuate artery system beneath the placenta within 8 days of delivery in 47 patients with type I diabetes mellitus. A placental pathologist, without knowledge of either clinical outcome or Doppler information, classified the histological appearance of the decidual arteries as normal, type A (hyalinization, mural thickening), or type B (fibrinoid necrosis, atherosis, thrombosis). Patients were then grouped according to the histology of the decidual arteries. An analysis of variance (ANOVA) of the systolic/diastolic (S/D) ratios (log. S/D) showed significant variation (p < 0.025). A multiple range comparison test showed that patients with normal or only mildly abnormal (type A) vessels had similar values, whereas those with severe vasculopathy (type B) had significantly higher S/D ratios (p < 0.05). The study confirmed a relationship between arcuate artery Doppler indices and downstream decidual vascular pathology.

    背景与目标: 目的是将子宫弓形动脉的多普勒指数与I型糖尿病患者蜕膜血管组织学分析相关联。在47例I型糖尿病患者的分娩后8天内,使用脉冲波多普勒对胎盘下方的子宫弓形动脉系统进行了采样。胎盘病理学家在不了解临床结果或多普勒信息的情况下,将蜕膜动脉的组织学外观分类为正常,a型 (透明化,壁增厚) 或b型 (纤维蛋白样坏死,动脉粥样硬化,血栓形成)。然后根据蜕膜动脉的组织学将患者分组。收缩期/舒张期 (S/D) 比 (log. S/D) 的方差分析 (ANOVA) 显示出显着差异 (p <0.025)。多范围比较测试显示,血管正常或仅轻度异常 (a型) 的患者具有相似的值,而具有严重血管病变 (b型) 的患者具有显着更高的S/D比 (p <0.05)。该研究证实了弓形动脉多普勒指标与下游蜕膜血管病理之间的关系。

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