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Clinical Application of Gastric Contrast-Enhanced Ultrasound in Diagnosis and Management of Hiatal Hernia. 胃超声造影在裂孔疝诊断和治疗中的临床应用。
Q4 Medicine Pub Date : 2025-10-01 DOI: 10.3881/j.issn.1000-503X.16646
Qing-Ling Jiang, Guang-Jian Liu

Hiatal hernia (HH) refers to a common digestive system disorder in which the stomach or other abdominal organs protrude into the thoracic cavity through the esophageal hiatus.With changes of people's lifestyles,accelerated aging,and rising rates of obesity and overweight,the incidence of HH in China has been steadily increasing.Early diagnosis and accurate classification of HH are critical for guiding treatment decisions. Conventional diagnostic methods-such as barium swallow X-ray,gastroscopy,computed tomography,and high resolution esophageal manometry-have limitations,including invasiveness,radiation exposure,high costs,or inadequate dynamic assessment.Gastric contrast-enhanced ultrasound,as a novel non-invasive imaging technique,has demonstrated unique advantages in the evaluation of HH in recent years.This article reviews the technical principles,clinical applications,and recent advancements of gastric contrast-enhanced ultrasound.

裂孔疝(HH)是一种常见的消化系统疾病,胃或其他腹部器官通过食道裂孔突出到胸腔内。随着人们生活方式的改变,老龄化的加快,肥胖和超重的增加,HH在中国的发病率一直在稳步上升。早期诊断和准确分类HH是指导治疗决策的关键。传统的诊断方法,如钡餐x线、胃镜检查、计算机断层扫描和高分辨率食管测压术,都有局限性,包括侵入性、辐射暴露、高成本或不充分的动态评估。胃超声造影作为一种新型的无创成像技术,近年来在HH的诊断中显示出独特的优势。本文就胃超声造影的技术原理、临床应用及最新进展作一综述。
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引用次数: 0
Application Value of Gastric Contrast-Enhanced Ultrasound in the Diagnosis of Extraluminal Duodenal Diverticulum. 胃超声造影在十二指肠憩室诊断中的应用价值。
Q4 Medicine Pub Date : 2025-10-01 DOI: 10.3881/j.issn.1000-503X.16656
Jing-Ya Zhang, Yan-Long Liu

Objective To evaluate the value of gastric contrast-enhanced ultrasound in diagnosing extraluminal duodenal diverticulum. Methods A retrospective analysis was conducted on 40 cases of extraluminal duodenal diverticula confirmed by upper gastrointestinal barium meal and gastroduodenoscopy,all of whom underwent gastric contrast-enhanced ultrasound examination.The detection rate and imaging features of duodenal diverticula were retrospectively analyzed. Results Gastric contrast-enhanced ultrasound detected 34 out of 40 cases of extraluminal duodenal diverticula,with the detection rate (85.0%) higher than that (10.0%,4/40) of conventional fasting ultrasound (P<0.001).Gastric contrast-enhanced ultrasound demonstrated higher detection rate for single diverticula than for multiple diverticula (97.1% vs.44.4%,P<0.001) and was particularly effective for duodenal diverticula in the descending segment (91.7%).According to imaging features,duodenal diverticula were classified into sac-like,gas-containing mass,and air-line types. Conclusion Gastric contrast-enhanced ultrasound facilitates the detection of extraluminal duodenal diverticula in the descending segment,allows concurrent visualization of biliary-pancreatic system pathologies,and enables comprehensive assessment of the association between duodenal diverticula and biliary-pancreatic diseases,demonstrating significant clinical value.

目的探讨胃超声造影对十二指肠憩室的诊断价值。方法回顾性分析经上消化道钡餐及胃十二指肠镜检查证实的40例十二指肠腔外憩室,所有病例均行胃超声造影检查。回顾性分析十二指肠憩室的检出率及影像学特征。结果胃造影增强超声检出率(85.0%)高于常规空腹超声检出率(10.0%,4/40)(Pvs.44.4%,P
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引用次数: 0
Research Progress in Clinical Applications of Gastric Contrast-Enhanced Ultrasound. 胃超声造影临床应用研究进展。
Q4 Medicine Pub Date : 2025-10-01 DOI: 10.3881/j.issn.1000-503X.16655
Qiao-Yun Zhao, Chun-Quan Zhang, Liang-Yun Guo

Gastric contrast-enhanced ultrasound is a non-invasive imaging method that uses oral gastrointestinal ultrasound contrast agents to fill the stomach cavity and display the structure and lesions of the stomach wall.In recent years,the development of contrast agents and the technological innovations of ultrasound equipment have boosted the unique advantages of this examination technique in the diagnosis of gastrointestinal diseases.Gastric contrast-enhanced ultrasound is becoming an important complementary examination means to gastroscopy and X-ray barium meal examination.In this paper,we summarize the clinical applications of gastric contrast-enhanced ultrasound at home and abroad in recent years and systematically analyze its clinical application value and limitations in six aspects:screening and staging of gastric cancer,differentiation and diagnosis of gastric tumors,diagnosis and follow-up of gastritis and gastric ulcers,assessment of gastric contents and gastric volume,evaluation of gastric emptying and gastric motility,and other special applications.

胃超声增强是利用口服胃肠道超声造影剂填充胃腔,显示胃壁结构及病变的一种无创成像方法。近年来,造影剂的发展和超声设备的技术革新,增强了该检查技术在胃肠道疾病诊断中的独特优势。胃超声造影正成为胃镜检查和x线钡餐检查的重要补充检查手段。本文综述了近年来胃造影增强超声在国内外的临床应用,并从胃癌的筛查与分期、胃肿瘤的鉴别与诊断、胃炎和胃溃疡的诊断与随访、胃内容物和胃容量的评估、胃排空和胃动力的评估以及其他特殊应用等六个方面系统分析了其临床应用价值和局限性。
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引用次数: 0
Gastric-Duodenal Contrast-Enhanced Ultrasound for Diagnosis of Gallbladder-Duodenal Fistula:Report of One Case. 胃十二指肠超声造影诊断胆囊-十二指肠瘘1例报告。
Q4 Medicine Pub Date : 2025-10-01 DOI: 10.3881/j.issn.1000-503X.16557
Ya-Jiao Gan, Qi-Ping Hu, Yi Tang, Zhi-Kui Chen

Gallbladder-duodenal fistula,a severe complication of cholecystitis caused by gallstones,is clinically rare.Its clinical presentation lacks specificity,and conventional preoperative imaging often fails to establish a definitive diagnosis.This report describes a case where a gallbladder-duodenal fistula was diagnosed using oral microbubble ultrasound contrast agent for gastric-duodenal contrast-enhanced ultrasound,providing a novel approach for diagnosing this condition.

摘要胆囊-十二指肠瘘是胆结石引起的胆囊炎的严重并发症,临床上罕见。其临床表现缺乏特异性,常规术前影像学往往不能建立明确的诊断。本报告描述了一个使用口服微泡超声造影剂进行胃十二指肠造影增强超声诊断胆囊-十二指肠瘘的病例,为诊断这种疾病提供了一种新的方法。
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引用次数: 0
Comparison of 24 h Ambulatory Blood Pressure Control Among Hypertensive Patients in Communities in Different Time Periods and Analysis of Its Influencing Factors. 社区不同时段高血压患者24 h动态血压控制情况比较及影响因素分析
Q4 Medicine Pub Date : 2025-10-01 DOI: 10.3881/j.issn.1000-503X.16379
Xiang Huang, Hua-Jie Yang, Yong-Jun Zheng, Yu-Ting Li, Jie-Zhen Feng, Hao-Xiang Wang, Ling Wang
<p><p>Objective To assess the blood pressure control and its influencing factors among hypertensive patients in communities in different time periods by 24 h ambulatory blood pressure monitoring(24 h ABPM)and provide reference for optimizing the health management services for hypertension in communities. Methods A total of 765 hypertensive patients registered in the hypertension management project of national essential public health services in Sanxiang Town,Zhongshan City from October 2022 to September 2023 were identified as target subjects.The 24 h ABPM devices were distributed for blood pressure monitoring and a questionnaire survey was conducted to analyze the influencing factors of blood pressure control. Results Of all the participants,16.5% did not monitor blood pressure regularly,and 59.2% monitored blood pressure 1-2 times per week.The patients who were not on night shifts/staying up late had higher mean rates of achieving the target blood pressure and the circadian rhythm of blood pressure during 24 h,nighttime,and early morning than those who were on night shifts/staying up late(all <i>P</i><0.05).The patients who never drank alcohol had higher rate of achieving the target blood pressure in early morning than those who drank alcohol(<i>P</i>=0.012).The average blood pressure during daytime,nighttime,and 24 h were different by sex(all <i>P</i><0.05).The average blood pressure during nighttime was different by age and job types(all <i>P</i><0.05).The average blood pressure during daytime,nighttime,and 24 h were different in patients with different body weight types(all <i>P</i><0.05).The results of the multivariate logistic regression analysis showed that uncontrolled blood pressure during daytime was more likely to occur in male patients(<i>OR</i>=1.394,95%<i>CI</i>=1.045-1.858,<i>P</i>=0.024),and that during nighttime was more likely to be associated with male patients(<i>OR</i>=1.573,95%<i>CI</i>=1.088-2.275,<i>P</i>=0.016)and night shifts(<i>OR</i>=2.467,95%<i>CI</i>=1.198-5.077,<i>P</i>=0.014).It was difficult to achieve blood pressure control in early morning for the patients who drank alcohol for more than three times per week(<i>OR</i>=4.567,95%<i>CI</i>=1.629-12.807,<i>P</i>=0.004),woke up at night(<i>OR</i>=1.800,95%<i>CI</i>=1.125-2.878,<i>P</i>=0.014),and had night shifts(<i>OR</i>=1.579,95%<i>CI</i>=1.102-2.465,<i>P</i>=0.044).The patients on night shifts were more likely to have abnormal circadian rhythm of blood pressure(<i>OR</i>=1.753,95%<i>CI</i>:1.018-3.018,<i>P</i>=0.043). Conclusions The personal characteristics and lifestyle of hypertensive patients significantly affect the blood pressure control in different time periods(daytime,nighttime,and early morning)and the circadian rhythm of blood pressure.The family doctor team of community healthcare institutions can implement targeted and precise intervention measures for hypertensive patients according to the influencing factors of blood pressure control in different
目的通过24 h动态血压监测(24 h ABPM),了解社区高血压患者不同时间段的血压控制情况及其影响因素,为优化社区高血压健康管理服务提供参考。方法选取2022年10月~ 2023年9月中山市三乡镇国家基本公共卫生服务高血压管理项目登记的高血压患者765例作为研究对象。采用24h ABPM装置监测血压,并进行问卷调查,分析血压控制的影响因素。在所有参与者中,16.5%的人没有定期监测血压,59.2%的人每周监测1-2次血压。不上夜班/熬夜的患者在24小时、夜间和清晨达到目标血压和血压昼夜节律的平均率高于上夜班/熬夜的患者(P
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引用次数: 0
Ménétrier's Disease:Report of One Case and Literature Review. 梅氏病1例报告并文献复习。
Q4 Medicine Pub Date : 2025-10-01 DOI: 10.3881/j.issn.1000-503X.16584
Ming-Yue Lü, Su-Su Li, Xin-Hua Zhang

Ménétrier's disease (MD) is a relatively rare special type of gastritis in clinical practice.This article reports the multiple diagnosis and treatment processes of a patient with MD in the northwest plateau region,reviews relevant literature,and summarizes the ultrasonic features of gastrointestinal contrast-enhanced ultrasound in this case and their value in the diagnosis and treatment process.Furthermore,this article discusses the key points of imaging differentiation of MD from chronic hypertrophic gastritis,multiple gastric polyps,gastric cancer,and gastric lymphoma.

msamnsamtrier 's disease (MD)是临床上比较少见的特殊类型胃炎。本文报道了西北高原地区1例MD患者的多重诊疗过程,回顾了相关文献,总结了该病例胃肠道超声造影的超声特征及其在诊疗中的价值。并讨论了MD与慢性肥厚性胃炎、多发性胃息肉、胃癌、胃淋巴瘤的影像学鉴别要点。
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引用次数: 0
Research Progress in Effect of Repetitive Noxious Stimuli in Neonatal Period on Neural Development. 新生儿期重复有害刺激对神经发育影响的研究进展。
Q4 Medicine Pub Date : 2025-10-01 DOI: 10.3881/j.issn.1000-503X.16266
Yan Li, Wen-Yu Zhang, Zhi Xiao, Xing-Feng Liu

The establishment and development of neonatal intensive care unit(NICU)have significantly increased the survival rate of premature infants.However,the diagnosis,treatment,and surgeries performed in NICU may expose neonates to more noxious stimuli.As the neonatal period is crucial for brain development,these noxious stimuli may cause irreversible damage to the neonatal nervous system.Existing clinical studies have shown that repetitive noxious stimuli during the neonatal period can lead to poor brain development,persistent hyperalgesia,and various sequelae.However,the underlying mechanisms remain unclear,and effective treatment methods are lacking.This article summarizes the effects of repetitive noxious stimuli during the neonatal period on neural development and the complications,aiming to provide a basis for the neonatal analgesia management and the prevention and treatment of related sequelae.

新生儿重症监护病房(NICU)的建立和发展显著提高了早产儿的存活率。然而,在新生儿重症监护室进行的诊断、治疗和手术可能会使新生儿暴露在更多有害的刺激下。由于新生儿时期是大脑发育的关键时期,这些有害的刺激可能会对新生儿神经系统造成不可逆转的损害。现有临床研究表明,新生儿期反复的有害刺激可导致大脑发育不良、持续性痛觉过敏和各种后遗症。然而,潜在的机制尚不清楚,缺乏有效的治疗方法。本文就新生儿期反复有害刺激对神经发育的影响及其并发症进行综述,旨在为新生儿镇痛管理及相关后遗症的防治提供依据。
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引用次数: 0
Advances in Clinical Application of Gastric Contrast-Enhanced Ultrasound for Gastric Cancer. 胃超声造影在胃癌诊断中的临床应用进展。
Q4 Medicine Pub Date : 2025-10-01 DOI: 10.3881/j.issn.1000-503X.16604
Guan-Mo Liu, Hua Liang, Yang Gui, Jie Li, Xin Ye, Wei-Ming Kang

Gastric contrast-enhanced ultrasound includes oral contrast-enhanced ultrasound (OCUS) and double contrast-enhanced ultrasound (DCEUS),which can provide valuable clinical information about tumor morphology,vascular characteristics,and treatment responses.OCUS can clearly identify the gastric wall structure and the extent and depth of lesions by applying oral contrast agents.DCEUS,based on OCUS combined with venography,can display the anatomical and perfusion characteristics of lesions.In recent years,gastric contrast agents and imaging techniques have developed rapidly.However,the clinical application of gastric contrast-enhanced ultrasound is still in the developmental stage.This article reviews the clinical status of OCUS and DCEUS in the screening,diagnosis,staging,pathological typing,and treatment evaluation of gastric cancer.Studies have shown that gastric contrast-enhanced ultrasound has high sensitivity and specificity in the assessment of diagnosis and T-staging of gastric cancer.Furthermore,gastric contrast-enhanced ultrasound has the advantages of being cost-effective,convenient,non-invasive,free from radiation exposure,real-time,and easy to repeat.In the diagnosis and treatment of gastric cancer,it is expected to become one of the important imaging assessment tools.

胃造影包括口服造影增强超声(OCUS)和双造影增强超声(DCEUS),可提供有关肿瘤形态、血管特征和治疗反应等有价值的临床信息。OCUS可以通过口服造影剂清晰地识别胃壁结构及病变的范围和深度。DCEUS在OCUS的基础上结合静脉造影,可以显示病变的解剖和灌注特征。近年来,胃造影剂和成像技术发展迅速。然而,胃超声造影的临床应用仍处于发展阶段。本文就OCUS和DCEUS在胃癌的筛查、诊断、分期、病理分型及治疗评价等方面的临床情况进行综述。研究表明,胃超声造影对胃癌的诊断和t分期评估具有较高的敏感性和特异性。此外,胃超声造影具有成本效益高、方便、无创、无辐射暴露、实时性好、易重复等优点。在胃癌的诊断和治疗中,有望成为重要的影像学评估工具之一。
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引用次数: 0
Effect of Folate Deficiency on the Changes of Histone H3 Lysine 4 Monomethylation-Marked Enhancers and Its Molecular Exploration in Low Folate-Induced Neural Tube Defects. 叶酸缺乏对低叶酸诱导的神经管缺陷中组蛋白H3赖氨酸4单甲基化标记增强子变化的影响及其分子探索
Q4 Medicine Pub Date : 2025-10-01 DOI: 10.3881/j.issn.1000-503X.16323
Qiu Xie, Jin Hu, Jian-Ting Li, Ting Zhang

Objective To investigate the effects of folate deficiency on changes in histone H3 lysine 4 (H3K4) mono-methylation (me1)-marked enhancers and the molecular mechanism underpinning the folate deficiency-induced neural tube defects (NTD). Methods Mouse embryonic stem cells (mESCs) were cultured in the folate-free DMEM medium (folate-deficient group) and the DMEM medium containing 4 mg/L folate (normal control group),respectively.Chromatin immunoprecipitation sequencing (ChIP-seq) was performed for H3K4me1. The mouse model of folate-induced NTD was established,and transcriptome sequencing (RNA-seq) was performed for the brain tissue of fetal mice to reveal the differential expression profiles.The results were validated through real-time quantitative polymerase chain reaction (RT-qPCR).The activity of the differential peak regions of H3K4me1 was verified through the luciferase reporter assay. Results The folate content in the mESCs cultured in the folate-free medium reduced compared with that in the normal control group (P=0.008).The H3K4me1-maked enhancers in the mESCs cultured in the folate-free medium induced significant changes in intronic regions,and these changes were concentrated in metabolic and energy metabolism processes (q=9.56×10-48,P=1.28×10-47).The differentially expressed genes harboring H3K4me1-marked enhancers in mESCs were mainly enriched in the Wnt signaling pathway (q=0.004,P=0.004 7).ChIP-qPCR results confirmed that H3K4me1 binding decreased in the differential peak regions of the Ldlrap1 gene (P=0.008),Camta1 gene (P=0.002),and Apc2 gene (P=0.012).The H3K4 demethylase inhibitor T-448 effectively reversed the H3K4me1 binding in the differential peak regions of the aforementioned genes (P=0.01).The results of RNA-seq for the brain tissue of NTD fetal mice showed significant enrichment of the differentially expressed genes in the Wnt signaling pathway (P=1.52×10-5).The enrichment of differential peak regions of H3K4me1-marked enhancers in Apc2,Ldlrap1,and Camta1 genes in the brain tissue also showed significant changes.The differential peak region in Apc2 exhibited transcription factor activity (P=0.020). Conclusion Folate deficiency may affect changes in H3K4me1-marked enhancers to participate in the regulation of neural tube closure genes,thereby inducing the occurrence of NTD.

目的探讨叶酸缺乏对组蛋白H3赖氨酸4 (H3K4)单甲基化(me1)标记增强子变化的影响及叶酸缺乏诱导神经管缺陷(NTD)的分子机制。方法小鼠胚胎干细胞(mESCs)分别在不含叶酸的DMEM培养基(叶酸缺乏组)和含4mg /L叶酸的DMEM培养基(正常对照组)中培养。对H3K4me1进行染色质免疫沉淀测序(ChIP-seq)。建立叶酸诱导的NTD小鼠模型,对胎鼠脑组织进行转录组测序(RNA-seq),揭示其差异表达谱。通过实时定量聚合酶链反应(RT-qPCR)对结果进行验证。H3K4me1的差异峰区活性通过荧光素酶报告基因实验验证。结果无叶酸培养基培养的mESCs中叶酸含量明显低于正常对照组(P=0.008)。在无叶酸培养基中培养的mESCs中,h3k4me1制造的增强子诱导了内含子区域的显著变化,这些变化集中在代谢和能量代谢过程中(q=9.56×10-48,P=1.28×10-47)。mESCs中含有h3k4me1标记增强子的差异表达基因主要富集于Wnt信号通路(q=0.004,P= 0.0047)。ChIP-qPCR结果证实,H3K4me1在Ldlrap1基因(P=0.008)、Camta1基因(P=0.002)和Apc2基因(P=0.012)的差异峰区结合减少。H3K4去甲基化酶抑制剂T-448有效逆转了上述基因差异峰区的H3K4me1结合(P=0.01)。NTD胎鼠脑组织RNA-seq结果显示Wnt信号通路差异表达基因显著富集(P=1.52×10-5)。脑组织中Apc2、Ldlrap1和Camta1基因中h3k4me1标记增强子的差异峰区富集也发生了显著变化。Apc2的差异峰区表现出转录因子活性(P=0.020)。结论叶酸缺乏可能影响h3k4me1标记的增强子改变参与神经管闭合基因的调控,从而诱发NTD的发生。
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引用次数: 0
Advances in Immunotherapy for Head and Neck Squamous Cell Carcinoma. 头颈部鳞状细胞癌的免疫治疗进展。
Q4 Medicine Pub Date : 2025-10-01 DOI: 10.3881/j.issn.1000-503X.16477
Yue Cao, Chun-Mei Bai

Head and neck squamous cell carcinoma(HNSCC) associated with a poor prognosis and diminished quality of life for patients is the most prevalent pathological type among head and neck tumors. Currently,the standard treatment modalities comprise systemic therapies(including chemotherapy,targeted therapy,and immunotherapy) and local therapies(surgery and radiotherapy).Immunotherapy,characterized by high specificity and low toxicity,is progressively expanding from advanced palliative care to the stage of locally advanced curative treatment and has demonstrated promising efficacy.This review summarizes the latest advances in immunotherapy for HNSCC,aiming to provide reference for optimizing clinical management strategies and facilitating the clinical research.

头颈部鳞状细胞癌(HNSCC)是头颈部肿瘤中最常见的病理类型,预后差,患者生活质量下降。目前,标准的治疗方式包括全身治疗(包括化疗、靶向治疗和免疫治疗)和局部治疗(手术和放疗)。免疫治疗具有高特异性和低毒的特点,正逐步从晚期姑息治疗扩展到局部晚期治愈治疗阶段,并显示出良好的疗效。本文综述了HNSCC免疫治疗的最新进展,旨在为优化临床管理策略和促进临床研究提供参考。
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引用次数: 0
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中国医学科学院学报
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