彩色多普勒超声与钼靶X线诊断乳腺错构瘤

目的 探讨彩色多普勒超声与钼靶X线对乳腺错构瘤的诊断价值.方法 分析97例疑是乳腺错构瘤病例,所有病例均在我院行彩色多普勒超声检查和/或钼靶X线检查,并经手术切除治疗,术后经病理检查确定病理性质.结果 彩色多普勒超声在敏感性(彩超:79.6%,钼靶:62.2%)、特异性(彩超:70.3%,钼靶:55.2%)、诊断准确率(彩超:75.6%,钼靶:59.1%)、阳性预测值(彩超:78.0%,钼靶:63.9%)和阴性预测值(彩超:72.2%,钼靶:53.3%)等方面均优于钼靶X线检查.彩色多普勒超声与钼靶X线诊断性研究的Youden指数分别为:0.50和0.17:彩色多普勒超声检查和钼靶X线的并联诊断,诊断的敏感性(88.2%)、特异性(90.5%)、诊断准确率(89.1%)、阳性预测值(93.8%)和阴性预测值(82.6%)均优于单纯彩色多普勒超声检查和钼靶X线,其Youden指数0.76.结论 彩色多普勒超声在本病的诊断中优于钼靶X线,在彩色多普勒超声和钼靶X线的并联研究中,诊断的敏感性、特异性、诊断准确率、阳性预测值和阴性预测值均有明显提高.     

乳腺癌采用超声影像和钼靶X线诊断的效果对比

目的：探究并对比乳腺癌采用超声影像和钼靶X线诊断的临床效果。方法选择行超声影像与钼靶X线检查,且诊断为乳腺疾病的患者86例,对比两种诊断方法的临床效果。结果对86例患者进行病理学检查,发现30例为良性病变（34.88%）,56例为乳腺癌（65.12%）。经过超声影像学诊断45例为真阳性,11例为假阴性;8例为假阳性,22例为真阴性。应用超声影像诊断的灵敏度为80.36%,特异度为73.33%,漏诊率为19.64%,误诊率为26.67%,准确率为77.91%。经过钼靶X线检查47例为真阳性,9例为假阴性,7例为假阳性,23例为真阴性。应用钼靶X线诊断的灵敏度为83.92%,特异度为76.67%,漏诊率为16.07%,误诊率为23.33%,准确率为81.39%。两种检查诊断结果总体率对比差异无统计学意义。结论乳腺癌采用超声影像和钼靶X线诊断均具有较高的准确率,钼靶X线适用于无明显结节或早期乳腺癌诊断,而超声影像在典型乳腺癌诊断方面灵敏度更高。     

420例乳腺良恶性肿瘤钼靶X线与病理诊断对比分析

目的分析乳腺良恶性肿瘤的钼靶X线表现特征,以提高乳腺肿瘤的术前诊断水平.方法对经术后病理检查证实的420例乳腺肿瘤与钼靶X线诊断结果对照.结果钼靶X线诊断的敏感性、特异性、准确性分别为95.79%、90.37%和94.05%,阳性预测值95.45%,阴性预测值91.04%,假阳性率和假阴性率分别为9.63%、4.21%.结论乳腺钼靶X线摄影是鉴别良恶性乳腺肿瘤的有效影像学方法.     

乳腺钼靶X线和乳腺高频彩超在乳腺癌检查中的对比研究

目的:通过不同病理类型乳腺癌患者的钼靶X线和高频彩超的诊断结果,对钼靶X线和高频彩超的发现率、准确率、假阴性率进行对比,比较两种检查方法在乳腺癌检查中的差别,从而为乳腺癌患者找到一种更适合的检查方法。方法:选择2006年4月～2007年12月间我院收治的乳腺癌患者86例进入本研究,按年龄、肿瘤最大直径、肿瘤位置、病理类型随机分为2组:乳腺钼靶X线组44例。高频彩超组42例。2组资料无统计学差异(P>0.05)具有可比性。此86例患者均进行了乳腺钼靶X线和高频彩超检查,其中钼靶X线组只考虑其X线检查笔果,高频彩超组只考虑其彩超检查结果,将结果全部与术后病理相对照。对此2组患者乳腺癌的发现率、准确率,假阴性率指标进行统计学分析。结果:乳腺钼靶X线组:44例患者发现肿物及相关病变者37例,其发现率为(94.09%),其中明确诊断乳癌者34例,准确率为77.27%(34/44),良、恶不能确定诊断3例,假阴性率为6,82%(3/44)。高频彩超组:42例患者发现肿物者41例,其发现率为/97.62%),其中明确诊断乳癌者38例,准确率为90.4～(38/42),良、恶不能确定诊断3例,假阴性率为7.14%(3/42)。锤组间在发现率上有统计学差异(P<0.05)。而准确率和假阴性率无统计学差异(P>0,05)。结论:通过对乳腺癌患者钼靶X线和高频彩超的对比研究,高频彩超的发现率与钼靶X线育差异,高频彩超在独立诊断乳腺癌方面较钼靶X线更有优势,但2者结合则更能弥补各自在诊断上的不足,减少漏诊的发生。     

乳腺钼靶X线联合MRI在触诊阴性乳腺癌诊断中的临床价值

目的 探究乳腺钼靶X线联合核磁共振成像(MRI)在触诊阴性乳腺癌(NPBL)诊断中的临床价值。方法 选择2021年4月至2022年11月本院诊治的触诊阴性乳腺癌患者123例作为研究对象,所有患者均行乳腺钼靶X线摄影、MRI成像及病理学检查,根据诊断结果分为阳性组及阴性组,对两种方法诊断结果与病理学诊断结果进行对比,分析二者联合诊断的价值。结果 钼靶X线联合MRI诊断NPBL准确率为94.31%,明显高于乳腺钼靶X线及MRI单独诊断的76.42%、80.49%(P<0.05);钼靶X线结果显示阳性组肿块边缘不光滑、肿块分叶征、肿块毛刺征、钙化情况为簇状分布、无包膜比例较阴性组明显升高(P<0.05);MRI结果阳性组肿瘤形态不规则、肿瘤边缘不光滑、不均匀强化、TIC形式Ⅲ型比例明显高于阴性组,ADC值及Tpeak明显低于阴性组(P<0.05)。结论 NPBL良恶性患者钼靶X线及MRI特征存在差异,二者联合对临床提高NPBL患者的诊效果具有重要意义。     

乳腺浸润性导管癌的钼靶X线和超声表现

目的:探讨钼靶X线和超声检查对乳腺浸润性导管癌的诊断价值.方法:搜集经病理证实的乳腺浸润性导管癌48例病例资料,术前患者均行双乳钼靶片及超声检查.结果:钼靶X线显示肿块42例,微小钙化灶25例,局部密度增高4例,钼靶X线对乳腺浸润性导管癌的阳性诊断率达95.8%;超声显示肿块46例,回声不均匀42例,血供丰富41例,超声检查对乳腺浸润性导管癌的阳性诊断率达95.8%;二者联合应用阳性诊断率为100%.结论:钼靶X线和超声检查对乳腺浸润性导管癌较具特征性,二者结合可明显提高诊断正确率.     

钼靶和立体定位芯针活检应用于临床触诊阴性乳腺病变

目的:探讨钼靶和立体定位芯针活检应用于临床触诊阴性乳腺占位性病变的作用。方法:对25例临床触诊阴性乳腺占位性病变患者进行回顾性分析,均行双侧全数字化钼靶乳腺X线摄影,再对肿块行立体定位穿刺,手术活检病理对照。结果:在25例乳腺病变检查中,X线钼靶摄片诊断符合率为84.2%,穿刺失误及假阴性各占7.9%。钼靶结合立体定位芯针活检诊断乳腺癌浸润的诊断符合率为84.2%,阳性预测值为100%。活检为良性的病变,平均随访22个月,未见恶性病例。操作过程中的并发症主要为神经血管综合征(4%),活检术后血肿(4%)。结论:钼靶和立体定位芯针活检术简便准确,对临床触诊阴性乳腺占位性病变是最佳的诊断方法,可以取代手术活检。     

乳腺钼靶X线及B超对乳腺癌诊断价值的比较

目的:比较乳腺钼靶X线和乳腺B超对女性乳腺癌的诊断价值?方法:回顾性分析164例乳腺癌患者的乳腺钼靶X线及乳腺B超检查结果,并与病理结果进行对照分析?结果:乳腺钼靶X线和乳腺B超的诊断正确率分别为79.27%(130/164)?82.32%(135/164),而假阴性率分别为20.73%(34/164)?17.68%(29/164),差异均无统计学意义(P > 0.05),钼靶X线与乳腺B超的联合诊断正确率为92.07%(151/164),与单纯钼靶X线或B超检查相比,差异均有统计学意义(P < 0.01)?结论:乳腺B超可作为钼靶X线的重要补充,以提高诊断正确率,降低假阴性率?     

ABVS联合X线钼靶对乳腺良恶性病灶的诊断价值

目的:探讨自动乳腺全容积扫描(ABVS)联合X线钼靶对乳腺良恶性病灶的诊断价值。方法:回顾性分析196例乳腺肿瘤患者的临床资料。根据术后病理学结果不同，分为恶性组(n=77)和良性组(n=119),探讨单独检查及二者联合检查的诊断价值，并绘制受试者工作特征(ROC)曲线。结果:在X线钼靶检查中，恶性组出现单纯微小钙化、结构紊乱征象的比例高于良性组(P<0.05);在ABVS检查中，恶性组出现“汇聚征”征象的比例高于良性组(P<0.05)。以病理学结果为“金标准”,ABVS联合X线钼靶的敏感度、特异度、阳性预测值、阴性预测值及准确性分别是97.40%、78.99%、75.00%、97.92%及86.22%,其敏感度高于X线钼靶和ABVS单独检查(P<0.05),阴性预测值高于X线钼靶检查(P<0.05)。ABVS联合X线钼靶的ROC曲线下面积为0.882(95%CI:0.828～0.924)。结论:ABVS和X线钼靶检查均是诊断乳腺良恶性病灶的有效手段，但二者联合能优势互补，进一步提高乳腺良恶性病灶诊断的敏感性。     

肿块型乳腺癌多模态MRI影像表现及其与CerbB-2、ER、PR相关性分析

目的探讨肿块型乳腺癌多模态核磁共振(MRI)影像表现及其与人表皮生长因子受体(CerbB-2)、雌激素受体(ER)、孕激素受体(PR)相关性分析。方法将海南西部中心医院2018年6月至2022年5月收治的90例乳腺癌患者纳入研究对象,全部患者入院后均行钼靶X线和多模态MRI检查。比较钼靶X线和多模态M RI对肿块型乳腺癌的检出率与诊断效能,并评估肿块型乳腺癌多模态MRI表现与细胞蛋白CerbB-2、ER、PR的表达阳性率,进而分析肿块型乳腺癌多模态MRI表现与细胞蛋白CerbB-2、ER、 PR的表达统计结果。结果90例患者通过病理检查检出肿块型乳腺癌患者58例,其检出率是64.44%;钼靶X线对肿块型乳腺癌的检出率是68.97%;多模态MRI对肿块型乳腺癌的检出率是87.93%;病理检查结果作为金标准,多模态MRI对肿块型乳腺癌的灵敏度、准确度、阴性预测值均高于钼靶X线对肿块型乳腺癌(P<0.05)。钼靶X线和多模态MRI对肿块型乳腺癌的特异度、阳性预测值比较,差异无统计学意义(P>0.05);经病理证实为肿块型乳腺癌患者58例,CerbB-2阳性者30例,ER阳性者35...     

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…     

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.     

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.     

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.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.