乳腺导管原位癌的钼靶X线表现与病理对照分析

目的分析乳腺导管原位癌的钼靶X线表现,并分析其与病理亚型间的联系。方法选取乳腺癌患者30例,观察患者钼靶X线的表现,并与病理进行分型、分级的对照。结果颗粒点状钙化容易出现在非粉刺型低核级乳腺导管原位癌中。结论乳腺导管原位癌的钼靶X线的表现有一定的特征,与病理的分型和分级密切相关,可以为选择临床治疗方法提供参考。     

隐匿性乳腺病灶钼靶X线表现与病理对照研究

目的 分析各种隐匿性乳腺病灶钼靶X线表现,及其与病理学的相关性,为临床诊疗提供参考.方法 经手术、病理证实的各种隐匿性乳腺病灶如导管原位癌、导管原位癌伴微浸润、导管内乳头状瘤、乳腺增生症、乳腺纤维瘤共122例钼靶X线表现,并与其病理结果对照.结果 10例导管原位癌钼靶X线表现为细沙样簇状钙化、结节样致密影、局部结构紊乱.13例导管原位癌伴微浸润X线表现为细沙样簇状钙化、放射状的毛刺影、血管影增多、局部结构紊乱、结节性致密影.18例导管内乳头状瘤X线表现为小结节影、局限性致密影.52例乳腺增生症X线表现为局限性致密影、结构紊乱.29例乳腺纤维瘤X线表现为孤立的结节、局限性致密影.结论 良、恶性隐匿性乳腺病灶的钼靶X线表现为常见的特征,恶性征象有细沙样不均质簇状浅钙化、局部结构紊乱等;良性征象有孤立的结节、局限性致密影、粗大钙化等;与相应病理学有高度相关性,在一定程度上可为临床诊疗提供参考.     

乳腺钼靶X线摄影在乳腺疾病患者诊断中的作用分析

目的:探讨乳腺钼靶X线摄影在临床触诊阴性乳腺疾病患者诊断中的效果。方法:回顾分析69例临床触诊阴性的乳腺疾病患者的临床资料,总结乳腺钼靶X线摄影和乳腺微小钙化灶在临床触诊阴性乳腺疾病患者诊断中的作用。结果:69例触诊阴性乳腺疾病患者中,良性钙化患者中有肿块影11例,无肿块影37例,以无肿块影居多;恶性钙化患者中有肿块影16例,无肿块影5例,以有肿块影居多;良性肿瘤患者微小钙化灶定位活检结果以乳腺增生最为常见,恶性肿瘤患者微小钙化灶定位活检结果以浸润性导管癌最为常见;良性乳腺疾病患者簇状钙化数、钙化点数目以及簇状钙化中钙化颗粒数均较少,钙化灶直径小,簇状钙化密度较低,钙化颗粒大小均匀;恶性乳腺疾病患者则刚好相反,差异有统计学意义(P<0.05)。结论:钼靶X线摄影对钙化灶敏感性高,对乳腺疾病患者的诊断准确率大,再加上费用低,操作简单,可提高乳腺癌患者的早期诊断率,实用性强,值得临床推广。     

钼靶检查对隐匿性乳腺癌的诊断价值

目的探讨钼靶检查在隐匿性乳腺癌中的X线表现及诊断价值。方法回顾性分析34例手术病理证实的隐匿性乳腺癌的钼靶X线表现。结果X线表现孤立模糊小结节影5例,簇状微小钙化18例,乳腺结构紊乱4例,单纯腋下淋巴结肿大4例,血管增多、增粗、迂曲3例。病理诊断浸润性导管癌20例,导管原位癌8例,小叶原位癌4例,浸润性小叶癌2例。结论通过对隐匿性乳腺癌的钼靶X线征象分析,说明钼靶检查在隐匿性乳腺癌的诊断方面具有较高的诊断价值。     

彩色多普勒超声及钼靶X射线在乳腺原位癌早期诊断的对比研究

目的：探讨在乳腺原位癌诊断中彩色多普勒超声与乳腺钼靶X线的诊断价值。方法：选择2013-01至2015-12期间于我院确诊并进行治疗的32例乳腺原位癌患者进行彩色多普勒超声与乳腺钼靶X线检查,观察彩色多普勒超声与乳腺钼靶X线影像学特点。结果：超声诊断18例患者出现边界欠清、不规则的低回声肿块,11例患者出现混合回声肿块,3例患者出现边界清晰、规则的低回声肿块。钼靶X线摄片显示17例患者出现毛刺状肿块,2例患者出现形态规则、边界清晰肿块,8例患者钼靶X线可见肿瘤微钙化,2例患者肿瘤可见簇状钙化灶,3例患者摄片可见乳腺腺体局部结构紊乱、增厚。Kappa评分均大于0.75,说明超声与钼靶X线检查与病理检查相比一致性较好。结论：超声与钼靶X线检查对临床乳腺良恶性病变均具有其特征性征象,对临床乳腺原位癌的诊断鉴别具有重要价值。     

钼靶导丝定位下钙化活检对乳腺癌的诊断价值

目的探讨钼靶X线导丝定位下钙化活检对乳腺癌的诊断价值。方法采用美国GE钼铑双靶X线机及数字化三维立体定位穿刺活检系统,对40例乳腺局限或簇状钙化且临床不能触及肿块的患者进行乳腺钙化灶细针导丝定位,在局麻下进行病灶活检。结果乳腺癌5例,包括浸润性导管癌2例,导管内癌1例,右乳灶状小叶原位癌可疑早期浸润1例,导管内癌早期浸润1例,乳腺增生症12例,囊肿11例。乳腺纤维腺瘤7例,乳腺导管扩张症3例,乳腺导管内乳头状瘤2例,乳腺癌检出率12．5％,诊断准确率100％。结论对于临床不可触及之钙化在钼靶X线导丝定位下乳腺活检术,定位准确,可进一步提高乳腺癌的诊断率,值得临床应用。     

钼靶X线诊断早期乳腺癌的应用

目的探讨钼靶X线在早期乳腺癌的图像特征和临床价值。方法回顾性分析经手术病理证实的60例早期乳腺癌患者的钼靶X线表现。结果 60例乳腺癌患者的钼靶X线表现为小结节肿块影30例,局灶性致密影6例,单纯钙化25例,不对称导管影增粗2例,血管影增粗4例和局部腺体结构扭曲5例。后经手术病理证实均为早期乳癌患者,其中浸润性导管癌32例,浸润性小叶癌10例,导管原位癌6例,小叶原位癌2例,黏液腺癌5例,髓样癌4例和粉刺癌1例。结论早期乳癌的X线表现为肿块、钙化、局灶性致密影、结构扭曲等直接或间接征象时,应及时活检,才能有效提高早期乳癌的检出率。     

乳腺浸润性导管癌的30例X线分析

目的 :加深对乳腺浸润性导管癌的认识 ,进一步提高其 X线诊断水平以便为临床选择治疗方法提供较可靠的参考指征。材料与方法 :30例乳腺浸润性导管癌均经手术病理证实。30例均为女性 ,临床可扪及包块 ,均拍摄双乳钼靶片。结果 :X线片中显示块影 2 1例 ,占 70 % ,大多边缘毛糙 ,呈星芒状、毛刺状或触角状 ,显示钙化灶 15例 ,占 5 0 % ,单个钙化 6例 ,成簇样钙化 9例 ,显示非对称性静脉增粗 7例 ,非对称性导管扩张 3例 ,乳晕增厚 3例 ,乳头凹陷 2例。结论 :目前 ,钼靶 X线摄片仍是检查乳腺癌的首选方法。大多数乳腺浸润性导管癌因其较为典型的块影和钙化特征 ,诊断可一目了然。若能得到高分辨、高质量的乳腺片 ,对乳腺浸润性导管癌的早期诊断尤为重要。笔者认为 ,普通钼靶 X线机应尽快向数字化钼靶机发展     

数字化钼靶X 线摄影在不典型乳腺癌中的诊断价值

目的 探讨数字化钼靶X 线摄影不典型乳腺癌的影像学特点,以提高不典型乳腺癌的诊断的正确率.方法 收集30例经手术病理证实的不典型乳腺癌患者的乳腺数字化钼靶X 线摄影影像学资料.结果10 例为局灶致密结节影,8 例钼靶X 线征象仅表现为簇状沙粒样钙化影,无明显肿块,6 例钼靶X 线表现为乳腺腺体局部结构扭曲变形,4 例钼靶X 线征象为局部星芒征像,2 例钼靶X 线征象无明确肿块及钙化征像显示.结论 局灶致密结节影、局部结构紊乱、簇样钙化、局部星芒征像为不典型乳腺癌重要的X 线征象.     

非肿块型乳腺癌钼靶X线征象分析

目的:分析非肿块型乳腺癌在钼靶X线检查中的影像学表现,以提高非肿块型乳腺癌的钼靶X线诊断水平。方法:搜集术前均行数字化钼靶X线检查、术后经病理证实的非肿块型乳腺癌患者42例,分析不同的影像学表现。结果:42例非肿块型乳腺癌中,X线表现为钙化21例,致密影12例,结构扭曲9例,同时伴随其他间接征象24例。病理结果分别是:浸润性导管癌24例,导管原位癌9例,浸润性小叶癌8例,小叶原位癌1例。结论:钼靶X线检查能显示非肿块型乳腺癌的多种恶性征象,仔细观察能做出初步诊断     

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…     

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.     

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.     

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.     

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.     

Acupuncture Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.