目的 探讨颅脑超声在高危新生儿颅内疾病的诊断应用。方法 2010年7月—2014年6月间在我院新生儿重症监护室(NICU)813例新生儿应用百胜Mylab Five型彩色多普勒超声诊断仪,探头频率5～7.5 MHz,进行常规颅脑超声检查。患儿取仰卧位,经前囱作矢状切面及冠状切面按顺序扫查,重点扫查几个标志性切面。头皮留置针遮盖前囟者先予拔除,以保证检查顺利进行。结果 超声异常者85.73%(697/813)。其中颅内出血45.62%(318/697)。早期脑室周围—脑室内出血(PIVH)88.05%(280/318),以I级和II级为多;大脑出血4.40%(14/318);丘脑出血2.22%(7/318);小脑出血1.89%(6/318);蛛网膜下腔出血1.89%(6/318);硬膜下出血1.57%(5/318)。缺氧缺血性脑损伤(HIHB) 36.01%(251/697)。足月儿缺氧缺血性脑病(HIE)67.33%(169/251),轻度HIE52.59%(132/251),中重度HIE14.74%(37/251)。早产儿缺氧缺血性脑病(PVL)33.67%(82/251),化脓性脑膜炎3.30%(23/697)。脑积水15.06%(105/697),以外围性脑积水多见。出院前复查: I度及II度PIVH大部分吸收,III级及IV级PIVH可见侧脑室扩大、脑实质液化性囊腔。大脑出血、丘脑出血、小脑出血均有不同程度吸收,严重者遗留液化性囊腔,蛛网膜下腔出血及硬膜下出血亦有不同程度地吸收。轻度HIE大部分恢复正常,中重度HIE 均有脑室扩大、脑萎缩、液化性囊腔。PVL后期见囊泡性改变。化脓性脑膜炎后期可见硬膜下积液及梗阻性脑积水。结论 颅脑超声便携,可床边,价廉,可重复,具有较实用临床应用价值。适用于新生儿颅内疾病的筛查及诊断。对脑中线部位脑室周围—脑室内出血,对脑积水的程度、预后具有特异性诊断价值。它可提示颅内病变类型、程度、部位及动态监测病情进展情况。对某些颅内病变如蛛网膜下腔出血,硬膜下腔出血,小脑出血则需要结合CT、MRI等其它影像技术,为临床诊断提供依据。

目的 探讨急性阑尾炎(acute appendicitis, AA)及急性感染性肠炎(acute infectious enteritis, AIE)患儿的阑尾高频超声影像特点及其显像敏感性。方法 回顾性分析临床确诊为急性阑尾炎患儿120例,急性感染性肠炎患儿160例,并对其行高频超声检查,另设120例正常儿童为对照组。分析高频超声阑尾显示率,阑尾外径,阑尾周围系膜炎性变化以及阑尾的位置等情况。结果 AA组、AIE组、对照组阑尾的显示率分别为96.7%、80.6%、68.3%,差异有统计学意义(P<0.05)。三组超声显示的阑尾外径分别为(8.5±2.2)mm、(4.3±0.8)mm、(3.5±0.7)mm,相互间差异亦均有统计学意义(P<0.05)。AA组所有的阑尾周围系膜炎症改变均可探及,但AIE组的阑尾周围系膜无变化。结论 小儿急性阑尾炎高频超声显像敏感性高,旨在为临床对AA早期诊断、早期治疗提供较准确全面的影像学依据。

Objective Use high-frequency ultrasound to determine the frequency of visualization and image feature of the appendix in children with acute appendicitis (acute appendicitis, AA) and with acute infectious enteritis (acute infectious enteritis, AIE). Methods The ultrasonic features of 120 children with AA, 160 children with AIE, and 120 randomly selected asymptomatic children were analyzed retrospectively. And their visualization rate, outer appendiceal diameter, presence or absence of inflamed periphery appendiceal mesenterium, and location of the appendix were recorded. Results The visualization rates of the appendix were 96.7%, 80.6%, and 68.3% for AA groups, AIE groups, and the control, respectively(P<0.05). The outer appendiceal diameters for the 3 groups were (8.5±2.2)mm, (4.3±0.8)mm, and (3.5±0.7)mm. Difference among the 3 groups was statistically significant also. Periphery appendiceal inflamed mesenterium was detected in all AA cases, but in none of the AIE cases. Conclusion High ultrasound imaging sensitivity of puerile acute appendicitis provided relatively accurate comprehensive imaging basis for clinical early diagnosis and early treatment.

目的 分析肺动脉栓塞超声心动图表现,探讨超声心动图估测肺动脉高压对肺动脉栓塞的诊断意义。方法 回顾性分析确诊肺动脉栓塞患者的超声心动图影像表现,就超声诊断征象进行对比分析。结果 累及肺动脉主干、两侧肺动脉近端的肺动脉栓塞检出率92.31%。肺动脉栓塞患者肺动脉高压检出率达78.38%。结论 经胸超声心动图估测肺动脉收缩压具有重要的诊断提示意义。

Objective To analyze the doppler echocardiography in the cases of pulmonary embolism and evaluate the relationship between pulmonary hypertension and pulmonary embolism. Methods To retrospectively analyze the echocardiography findings of the pulmonary hypertension. The causes of disease were classification analyzed. Results The detection rate of the embolus in the main pulmonary trunk and proximal pulmonary arteries is 92.31%. The detection rate of the pulmonary hypertension is 78.38%. Conclusion The estimation of pulmonary artery pressure in the echocardiography is helpful to diagnosis.

目的 探讨超声定位技术在重度水肿患儿颈内静脉置管中的应用效果。方法 选择重度水肿患儿23例,年龄1岁4个月～6岁,在超声引导下行颈内静脉置管。结果 本组23例患者均置管成功,置管成功率为100％,一次性穿刺成功率为91.3％,无1例发生出血、血气胸、血肿、空气栓塞等并发症。结论 超声引导定位重度水肿患儿颈内静脉置管,能有效提高穿刺成功率,减少并发症的发生。

目的 探讨二维超声联合三维超声检测不同孕期胎儿肢体畸形的临床价值。方法 回顾性分析我科2013年1月—2015年1月超声筛查的1352名孕15~34周的孕妇,运用二维及三维超声,采用连续顺序追踪超声法检测胎儿四肢,将产前诊断结果与引产或引产结果对照。结果 1352名孕妇胎儿畸形46例(3.40%,46/1352),总涉及肢体73处(近端肢体畸形65处,远端肢体畸形8处),其中四肢短小9例(骨发育不全2例,单纯四肢短小畸形5例,成骨发育不全2例),漏诊2例;足畸形16例34处,漏诊1例,残肢畸形15例;手畸形6例,漏诊1例。结论 孕中期二维连续顺序追踪超声法联合三维超声胎儿肢体畸形检出率高,对及早发现胎儿肢体畸形有一定的诊断价值。

目的 建立胎儿左、右肺面积及肺头比的正常参考值范围。方法 对501例正常单胎妊娠12～40周胎儿在标准四腔心切面应用手工描绘法分别描迹左肺、右肺面积,分别除以头围获得左、右肺头比。结果 获得正常妊娠胎儿左、右肺面积及肺头比各孕周参考值范围。胎儿左、右肺面积及肺头比均随孕周的增长而增大。结论 正常妊娠胎儿左、右肺面积及肺头比与孕周呈正相关。不同孕周LHR参考值的建立有利于临床评价膈疝及其他胸腔占位性疾病的预后。

Objective To establish reference intervals for fetal left and right lung areas and lung area to head circumference ratio (LHR). Methods In 501 cases of normal singleton pregnancy between 12 to 40 weeks, the left and right lung areas were measured respectively by ultrasound in the standard four chamber view, using manual tracing of the limits of the lungs. The left and right LHR were calculated when head circumferences were divided by the left and right lung area. Results Normal fetal reference intervals of left and right lung areas and LHR with gestational age were obtained. Fetal left and right lung areas and LHR increased with gestational age. Conclusion Fetal left and right lung areas and LHR values positively correlated with gestational age in normal pregnancy. Normal reference intervals of fetal LHR for every gestational age are valuable for evaluation of prognosis of fetal diaphragmatic hernia and other pulmonary peripheral space-occupying lesions.

       目的   分析早期结直肠癌内镜下治疗前行窄带成像结合放大内镜 （ME-NBI）和超声内镜技术的评估价值。方法   采用回顾性分析方法，以2021年1月— 2023 年 12月中山市第五人民医院收治的102例早期结直肠癌患者为观察对象，所有患者均接受内镜下黏膜切除术（EMR）或内镜黏膜下剥离术（ESD）治疗，根据内镜下治疗前是否进行ME-NBI和超声内镜检查分为研究组与对照组各51例。比较两组年龄、性别、肿瘤大小、直乙结肠占比及组织病理特征；比较两组治疗时间、ESD治疗后非治愈性切除发生率、治愈性切除率、并发症发生情况及再次ESD或外科手术治疗率。结果   两组年龄、性别、肿瘤大小、直乙结肠占比及组织病理比较差异均无统计学意义（P＞0.05）。研究组中37例行ESD治疗，治疗时间为（120.6±140.3）min，12例行EMR治疗，治疗时间为（11.6±9.3）min，有2例不符合内镜下治疗指征，转外科手术治疗。对照组有38例行ESD治疗，治疗时间为（128.8±144.5）min，13例行EMR治疗，治疗时间为（12.5±9.5）min，两者治疗时间比较差异均无统计学意义（P＞0.05）。研究组非治愈性切除率为7.84，低于对照组27.45；治愈性切除率为88.24，高于对照组72.55；研究组ESD手术并发症为8.11%，低于对照组31.58；ESD或外科手术率为6.12，低于对照组25.49（P＜0.05），结论  ME-NBI和超声内镜对早期结直肠癌患者行内镜下治疗指征评估更准确，可提高治愈性切除率。

       Objective  To  study the application value of magnifying endoscopy combined with  narrow  band imaging （ME-NBI）and ultrasonic endoscopy system before endoscopic treatment in patients with early colorectal cancer．Methods  A retrospective analysis was carried out on  102  patients with early-stage colorectal cancer who were admitted to Zhongshan Fifth People’s Hospital from January 2021 to December 2023．All patients were treated with endoscopic mucosal resection（EMR）or endoscopic submucosal dissection（ESO）．The patients were divided into study group（51 cases）and control group（51 cases）according to whether ME-NBI and ultrasonic endoscopy was performed before endoscopic treatment or not．The patient age，sex，volume of tumor，location of tumor and pathological result of the tumor were compared between two groups．Time for treatment，curative resection rate，non-curative resection rate and the complication incidence of ESD，incidences of second ESD or surgery were compared between the two groups．Results  There were no statistical differences in age，sex，volume of tumor，location of tumor and pathological result of the tumor（P＞0.05）．In the study group，37 patients received ESD treatment，operation time was（120.6±140.3）minutes，and 12 patients received EMR treatment，operation time was（11.6±9.3）minutes，two cases were transferred to surgery due to endoscopic ultrasonography combined with magnifying endoscopy showed that they did not meet the indications for ESD treatment．In the control group，38 patients received ESD treatment，operation time was（128.8±144.5）minutes，13 patients received EMR treatment，operation time was（12.5±9.5）minutes．There was no significant difference in treatment duration between the two groups．The non-curative resection rate of the study group was 7.84%，which was significantly lower than that in the control group（27.45%），and the curative resection rate（88.24%）was significantly higher than that in the control group（72.55%）．The complications of ESD surgery in the study group were 8.11%，lower than 31.58% in the control group．The rate of second ESD or surgery was 6.12%，lower than 25.49% in the control group（P＜0.05）．Conclusions  ME-NBI and endoscopic ultrasound are more accurate in the evaluation of endoscopic indications for early colorectal cancer patients，and can improve the curative resection rate．

      作为中医药文化瑰宝，针灸在疾病治疗中展现出独特价值，但其标准化操作、疗效量化评价及安全风险控制仍是制约现代化转型的关键问题。随着人工智能技术的突破性发展，机器学习在医疗领域引发的技术革命为针灸创新提供了新机遇。超声医学凭借可视化、定量化及动态监测优势，与机器学习算法形成技术协同，推动传统针灸向精准化、智能化方向迈进。通过超声成像实时定位穴位层次结构与针体轨迹，结合机器学习对多维数据的深度分析，显著提升了针刺治疗的精准性与安全性，同时为建立客观疗效评价体系提供了技术支撑。文章旨在全面回顾超声引导下机器学习技术在针灸研究领域的应用状况，深入剖析现有研究中存在的挑战与局限，并前瞻性地探讨未来的研究方向与趋势，旨在为针灸实践与应用研究的深化与发展提供理论指导与实践启示。

      As an invaluable component of traditional Chinese medicine，acupuncture boasts a distinctive value in the 

treatment of diseases．However，the standardization of its practice，the quantitative assessment of its therapeutic efficacy，and the implementation of safety risk control measures remain pivotal challenges hindering its modernization and transformation．The advent of artificial intelligence technology has precipitated a technological revolution in the medical field，thereby generating novel opportunities for innovation in acupuncture．The integration of ultrasound medicine and machine learning algorithms，leveraging their respective strengths in visualization，quantification and dynamic monitoring，has emerged as a technological synergy．This synergy is poised to propel traditional acupuncture towards precision and intelligence．The integration of ultrasound imaging with machine learning algorithms enables real-time localization of acupoints and needle trajectory，enhancing the precision and safety of acupuncture treatment．Additionally，it facilitates the development of objective efficacy evaluation systems．The present article aims to comprehensively  review the application of ultrasound-guided machine learning technology in the field of acupuncture and moxibustion research．It does so by first analyzing the challenges and limitations of existing research and then prospectively exploring future research directions and trends．The article’s ultimate aim is to provide theoretical guidance and practical inspiration for the deepening and development of acupuncture and moxibustion practice．

          目的   探讨便携式超声仪超声重点评估（e-FAST）技术在批量伤员军地联合院前救治中的应用效果。方法    抽取2021年5月—2023年10月中国人民解放军联勤保障部队第九八八医院中心急诊科收治的80例批量伤员，均开展军地联合院前救治，按照治疗方案不同分为观察组和对照组，每组患者40例，其中对照组在救治现场行基于创伤严重程度（CRAMS）评分，进行常规急救处置，救护车返院后行CT检查并进行相应伤情治疗，观察组救治现场行CRAMS评分，进行常规急救处置，院前接诊医师在现场或救护车上使用便携式超声仪按照e-FAST流程检查相应部位，初步诊断后进行相应伤情治疗，对比两组患者治疗效果，两组患者诊断时间、初次医疗接触—进入手术室时间及入院诊断与出院时确定性诊断的符合率、两组患者治疗前后CRAMS评分及CRAMS≤8分抢救成功率。结果   观察组治疗有效率为95.0%，对照组为85.0%，对比差异无统计学意义（χ ² =2.222，P=0.136）；观察组患者的诊断时间（13.56±2.36）min、初次医疗接触—进入手术室时间（30.42±8.99）min均短于对照组［（23.64±5.69）、（52.27±12.60）min］，差异有统计学意义（t=10.349、8.928，P＜0.05）；观察组患者入院诊断与出院时确定性诊断的符合为97.5%，对照组患者入院诊断与出院时确定性诊断的符合为95.0%，差异无统计学意义（χ ² =0.346，P=0.556）；治疗后两组患者的CRAMS评分均升高，且观察组（9.87±2.62）分高于对照组（8.60±2.98）分，差异有统计学意义（t=2.024，P=0.046）；观察组患者CRAMS≤8分的抢救成功率为97.50%，对照组CRAMS≤8抢救成功率为85.00%，观察组患者CRAMS≤8分的抢救成功率高于对照组（χ ² =3.914，P=0.048）。结论    本研究从军地联合救治批量伤员切入，瞄准部队医院军民融合战略发展路线，本文针对便携式超声仪e-FAST应用范围前移，明显地提高急救人员院前救治能力，提高抢救成功率，值得临床参考。

       Objective  To explore the application effect of portable ultrasound e-FAST technology in the pre hospital treatment of batch wounded soldiers in military civilian joint hospitals．Methods  Eighty batch wounded patients admitted to the emergency department of 988 Hospital from May 2021 to October 2023 were selected，all of whom underwent military civilian joint pre hospital treatment．They were divided into an observation group and a control group according to different treatment plans，with 40 patients in each group．The control group received CRAMS scores at the treatment site for routine first aid treatment，CT scans after ambulance return to the hospital for corresponding injury treatment，the observation group  received CRAMS scores at the treatment site for routine first aid treatment，and the pre-hospital attending physician used a portable ultrasound instrument to examine the corresponding parts on site or in the ambulance according to the e-FAST process．After preliminary diagnosis，corresponding injury treatment was carried out．The treatment effects of the two groups of patients were compared，and the diagnosis time and initial diagnosis of the two groups of patients were compared．The time from medical contact to entering the operation room，the compliance rate of discharge and admission diagnoses，the CRAMS score before and after treatment，and the success rate of rescue with CRAMS ≤ 8 for both groups of patients were compared．Results  The effective rate of treatment in the observation group was 95.0%，while in the control group it was 85.0%，which difference was not statistically significant（χ ² =2.222，P=0.136）．The time to diagnosis（13.56±2.36）min，time to the operating room（30.42±8.99）min were shorter than that in the control group［（23.64±5.69），（52.27±12.60）min］，with significant difference（t=10.349，8.928，P＜0.05）．The consistency  between the admission diagnosis and the definitive diagnosis at discharge of the observation group patients was 97.5%，while the consistency of the control group patients was 95.0%．There was no significant difference between the groups（χ ² =0.346，P=0.556）．After treatment，the CRAMS scores of both groups of patients increased，the observation group（9.87±2.62）was higher than that of the control group（8.60±2.98）（t=2.024，P=0.046）．The success rate of CRAMS ≤ 8 rescue in the observation group was 97.50%，while the success rate in the control group was 85.00%．The success rate of CRAMS ≤ 8 rescue in the observation group was higher than that in the control group（χ ² =3.914，P=0.048）．Conclusions  This study focuses on the joint treatment of batch wounded soldiers by military and civilian forces，aiming at the development path of military civilian integration strategy in military hospitals．The application scope of portable ultrasound e-FAST has been moved forward，which significantly improves the pre hospital treatment ability of emergency personnel and improves the success rate of rescue．It is worth clinical reference．

      目的   探讨分析超声引导下胸膜活检（USPB）联合胸腔积液检验对于临床确诊结核性胸膜炎的应用价值。方法   选取2021年6月—2023年6月广州市胸科医院收治的96例临床诊断为结核性胸膜炎（渗出性胸膜炎）的患者为研究对象，分别使用胸腔积液检验（包含胸腔积液腺苷脱氨酶及细菌培养）、USPB、两者联合三种方法诊断，计算其准确率、特异度及灵敏度并进行分析。结果   胸腔积液诊断准确率73.96%、灵敏度72.84%，USPB诊断准确率为85.42%、灵敏度82.71%，两者联合诊断准确率为88.54%，灵敏度90.12%，较胸腔积液检验单独诊断准确率及灵敏度明显升高（P＜0.05），胸腔积液、USPB、两者联合诊断特异度差异（P＞0.05）无统计学意义。结论  USPB联合胸腔积液检验对结核性胸膜炎的确诊具有较高临床价值。

       Objective  To investigate the value of ultrasound-guided pleural biopsy（USPB）combined with  pleural effusion test in the diagnosis of tuberculous pleurisy．Methods  A total of 96 patients with tuberculous pleurisy（exudative pleurisy）admitted to the Guangzhou Chest Hospital from June 2021 to June 2023 were selected．The accuracy，specificity，and sensitivity of pleural effusion test（including adenosine deaminase and bacterial culture），USPB，and their combination were calculated and analyzed．Results  The diagnostic accuracy of pleural effusion was 73.96% and the sensitivity was 72.84%．The diagnostic accuracy of USPB was 85.42% and the sensitivity was 82.71%．The diagnostic accuracy 88.54% and sensitivity 90.12% of USPB combined with pleural effusion test were significantly higher than that of pleural effusion alone（P＜0.05），but there was no significant difference in the diagnostic specificity of pleural effusion，USPB and combination of them（P＞0.05）．Conclusions  USPB combined with pleural effusion test has high clinical value in the diagnosis of tuberculous pleurisy．