超声与钼靶X线联合应用对乳腺癌的诊断价值

目的探讨超声诊断与钼靶X线联合应用对乳腺癌的诊断价值。方法对乳腺检查发现的65例可疑早期乳腺癌患者术前1周分别行乳腺钼靶、高频超声及联合检查,所有病例均经穿刺活检或手术病理证实。对所得数据运用统计学方法分析。结果65例患者超声检查诊断为恶性40例,良性25例;钼靶X线诊断恶性为29例,良性36例;病理检查诊断为恶性47例,良性18例。高频超声检查的敏感性、特异性、准确性、阳性预测值、阴性预测值及假阳性率、假阴性率分别是66．0％,44．4％,60．0％,75．6％,33．3％,55．6％,34．0％;钼靶检查分别是44．7％,77．8％,53．8％,84．0％,35．0％,22．2％,55．3％,两种方法比较差异有显著性。两者联合应用的各指标分别是85．1％,83．3％,84．6％,93．0％,68．2％,16．7％,14．9％,敏感性、特异性、准确性比单一方法有明显提高,而假阳性率和假阴性率显著降低。结论对于早期乳腺癌的诊断,高频超声检查优于钼靶检查,两种方法联合应用检查优于单一方法检查,能显著提高早期乳腺癌诊断的敏感性、特异性及准确性,降低假阳性及假阴性,具有较高的临床应用价值。     

肾脏实性占位病变诊断中应用超声造影技术的可行性及优越性分析

目的：分析肾脏实性占位病变诊断中应用超声造影技术的可行性及优越性。方法：选取2013年1月至2016年6月86例肾脏实性占位病变患者对观察对象。所有患者均行常规超声检测和超声造影检测,观察两种检测方法的特异性、准确性、敏感性、阳性预测值和阴性预测值。结果：将病理学检验结果作为金标准,超声造影的特异性、准确性、敏感性、阳性预测值和阴性预测值分别为：94．2％、96．5％、93．0％、74．4％和100．0％;而常规超声的特异性、准确性、敏感性、阳性预测值和阴性预测值分别为：72．1％、70．9％、59．3％、19．7％、94．2％,超声造影与常规超声在特异性、准确性及阳性预测值方面的比较差异有统计学意义（P ＜0．05）,但在敏感性和阴性预测值方面的比较差异无统计学意义。结论：肾脏实性占位病变诊断中应用超声造影技术具有较高的特异性、准确性和敏感度,对于临床诊断及鉴别具有较高的应用价值。     

乳腺三算子及血氧功能成像技术在乳腺癌诊断中的应用

目的探讨乳腺三算子及血氧功能成像技术在乳腺癌诊断中的应用价值。方法对146例患有乳腺疾病的妇女行体格检查、三算子及血氧功能成像,超声和（或）乳腺X线检查。共发现153个病灶。在这些病灶中,四项检查中至少有一项提示需要接受手术,通过与术后病理对比,得出各自影像学诊断的准确性。结果146例中61例为恶性。超声检查的敏感性为80．33％,特异性为89．41％,准确性为85．61％,阳性预测值84．48％,阴性预测值86．36％。乳腺x线检查的敏感性为57．89％,特异性为80．36％,准确性为69．03％,阳性预测值75．00％,阴性预测值65．22％。三算子及血氧功能成像检查的敏感性为91．80％,特异性为83．53％,准确性为86．99％,阳性预测值80．00％,阴性预测值94．67％。结论三算子及血氧功能成像检查对乳腺病灶诊断的敏感性、准确性、阴性预测值均优于乳腺X线检查和超声检查,特异性和阳性预测值介于两者之间,对乳腺癌的筛查及诊断有较大应用价值。     

超声引导真空辅助活检对乳腺癌诊断价值的研究

目的探讨超声引导真空辅助活检（VAB）对乳腺癌的诊断价值。方法回顾性分析接受术前超声引导VAB的825例乳腺癌的临床资料。结果817例VAB病理与术后病理诊断一致,8例组织学低估（0．96％）。与术后肿瘤标本对比,36例乳腺癌VAB取材标本ER、HER-2检测的准确性、敏感性、特异性、阳性预测值和阴性预测值分别为91．4％、86．7％、95．0％、92．9％、90．5％,88．6％、87．5％、90．9％、95．5％和76．9％。12例超声提示良性病变且肿瘤〈2cm的患者接受肿瘤VAB切除术,VAB病理示浸润性癌,均行进一步手术治疗,术后病理示3例活检残腔未见残留癌,9例残腔见癌成分及不典型增生。结论VAB对乳腺癌患者术前提供明确病理诊断,为进一步手术、新辅助化疗提供诊断依据,同时VAB获得的肿瘤组织可行相关预后及预测指标检测。但VAB无法做到对“小乳腺癌”的完全切除,接受 保乳手术的患者仍然需要接受进一步扩大切除,保证切缘阴性。     

70例平板运动试验阳性者与冠状动脉造影结果比较

目的：探讨平板运动试验对冠心病无症状心肌缺血（SMI）的诊断价值。方法：对70例临床疑诊SMI的患者，进行平板运动试验后行冠脉造影，并对其敏感性、特异性、准确性指数、阳性预测值及阴性预测值进行计算。结果：运动平板试验的敏感性为92．7％，特异性为40％，准确性为82％，阳性预测值为80．9％，阴性预测值为40．9％。结论：平板运动试验检出SMI特异性较低，敏感性高，是一种较为安全可行、无创的检查方法。     

超声评分法在甲状腺结节鉴别诊断中的价值

目的：探讨一种准确率高,容易为超声医师掌握和量化的评估甲状腺结节的方法。方法：对我院超声检出并经病理确诊的244个甲状腺结节进行回顾性评分,利用甲状腺结节超声评分法,计算超声评分法判断甲状腺结节良恶性的敏感性、特异性、阳性预测值及阴性预测值,拟定甲状腺良恶性结节评分临界值。结果：甲状腺结节超声评分法以4分为临界值,其敏感性为85．7％,特异性为83．2％,阳性预测值为70．2％,阴性预测值为92．7％;以5分为临界值,其敏感性为71．4％,特异性为92．8％,阳性预测值为82．0％,阴性预测值为87．5％;以6分为临界值,其敏感性为49．4％,特异性为95．8％,阳性预测值为84．4％,阴性预测值为80．4％。其中4分为临界值敏感性最高,6分为临界值特异性最高,最佳临界值为4分。结论：甲状腺结节超声评分法提高了良恶性甲状腺结节定性评估的准确率,特别是对微小癌的诊断更具有较高的临床价值。     

阴道超声与宫腔镜检查在诊断老年女性子宫内膜病变中的应用对比

目的：在老年女性子宫内膜病变中阴道超声与宫腔镜检查的应用对比。方法对2009年2月至2012年12月来我院就诊的109例因停经后阴道不规则流血的老年女性的临床资料进行了回顾性分析,所有患者来院后均行阴道超声检查,并同时进行宫腔镜检查,在宫腔镜下取内膜组织送病理,并根据病理结果对经阴道超声与宫腔镜检查的准确性进行对比。结果阴道超声对宫腔内病变的敏感性、特异性、阴性预测值、阳性预测值、假阳性率、假阴性率分别为90．7％、81．8％、93．1％、76．5％、23．5％、6．9％,对于子宫内膜癌及癌前病变的上述指标分别为100．0％、70．8％、100．0％、31．7％、68．3％、0;宫腔镜对子宫内病变的敏感性、特异性、阴性预测值、阳性预测值、假阳性率、假阴性率分别为95．3％、87．9％、96．7％、83．7％、16．3％、3．3％,对子宫内膜癌前病变及癌的上述指标分别为92．3％、85．4％、86．7％、46．2％、58．3％、13．3％。结论对于老年女性阴道出血的常规检查方式可选用阴道超声,但宫腔镜检查在内膜病变的诊断中有更高的准确性。     

超声在乳腺癌治疗中的对比分析

目的：分析超声在乳腺癌治疗中的价值。方法：选取2009年10月-2013年10月我院收治的38例乳腺癌患者,收取其高频彩色多普勒超声诊断结果,并以临床诊断结果作为参考,对乳腺癌的高频超声诊断效果进行评估。结果：超声诊断阳性35例,阴性3例;通过手术确定阳性36例,阴性2例。表明超声诊断的敏感性和特异性分别为92．1％和66．7％。结论：彩色多普勒超声在乳腺癌诊断方面有较高的临床应用价值。     

超声光散射成像与超声弹性成像技术联合应用在乳腺癌诊断中的价值

目的：探讨超声光散射成像（diffused optical tomography,DOT）与超声弹性成像技术（ultrasonic elastography,UE）联合应用在乳腺诊断中的价值。方法：通过117例患者的179个病灶分别进行DOT和UE检查,并与病理结果对照,对比分析DOT及UE在乳腺癌超声诊断中的敏感度、特异度、准确度、阳性预测值、阴性预测值。结果：DOT对乳腺癌诊断的敏感度87．14％、特异度79．82％、准确率82．68％、阳性预测值73．49％、阴性预测值90．62％。UE对乳腺癌诊断的敏感度72．86％,特异度90．83％、准确率83．80％、阳性预测值83．61％、阴性预测值83．90％。联合应用DOT和UE的敏感度91．43％、特异度92．66％、准确率92．18％、阳性预测值88．89％,阴性预测值94．39％。结论：DOT和UE检查均为有效的诊断方法,联合应用DOT和UE可以提高乳腺癌的诊断效能,对临床治疗方案的选择及患者的预后具有重要的意义。     

伴有肾动脉狭窄的冠心病患者心绞痛表现分析

目的分析冠心病患者合并肾动脉狭窄时的心绞痛临床特点,并判断其对冠心病的诊断价值。方法对象为1998年1月至2005年5月同时进行肾动脉和冠状动脉造影的住院患者2820例。心绞痛3组症状包括时间性质部位符合心绞痛、劳力情绪诱发和休息硝酸甘油缓解。任何一支肾动脉和冠状动脉血管直径狭窄超过50％可以分别诊断为肾动脉狭窄和冠心病。结果合并肾动脉狭窄组243例（85．6％）,无肾动脉狭窄组2577例。以胸痛休息硝酸甘油缓解、劳力情绪诱发、时间性质部位符合心绞痛等一组症状,诊断合并肾动脉狭窄的冠心病患者,敏感性分别为94．2％、69．7％和75．5％,特异性14．3％、40．0％和25．7％,阳性预测值86．7％、87．3％和85．8％,阴性预测值29．4％、18．2％和15．0％。以胸痛休息硝酸甘油缓解和劳力情绪诱发、时间性质部位符合心绞痛和劳力情绪诱发、时间性质部位符合心绞痛和休息硝酸甘油缓解等2组症状,诊断合并肾动脉狭窄患者的冠心病,敏感性分别为68．8％、56．7％和72．6％,特异性40．0％、62．9％和45．7％,阳性预测值87．2％、90．1％和88．8％,阴性预测值17．7％、19．6％和21．9％。心绞痛3组症状对于合并肾动脉狭窄患者的冠心病的诊断,敏感性为56．4％、特异性62．9％、阳性预测值90．0％和阴性预测值19．5％。结论心绞痛1组、2组或3组症状,对于冠心病诊断的敏感性和漏诊率以及多数特异性和误诊率,在是否合并肾动脉狭窄的患者中无显著差异,在肾动脉狭窄的患者中,阳性预测值偏大、阴性预测值偏小。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.