乳腺高频钼靶X线检查中细小钙化的探讨

目的：通过高频钼靶X线检查发现早期乳腺癌。方法：回顾性分析60例临床及B超阴性的隐性乳腺癌，做乳腺高频钼靶X线检查，观察病变的部位、大小、形态、边缘、密度及其分布情况。结果：乳腺癌13例占21．7％，乳腺纤维腺瘤7例占8．6％，乳腺腺病40例占66．7％。乳腺癌在钼靶X线照片显示乳腺实质内的针尖样、小分枝状或泥沙样钙化病灶，密度均匀一致，多发成簇。乳腺良性疾病在钼靶X线照片显示乳腺实质和间质中的小点状、小杆状或粗大圆形钙化病灶，大小不一，密度不均匀，数目小且分布散在。结论：乳腺高频钼靶X线检查能够发现临床及B超阴性的隐性乳腺癌，大大提高早期诊断率，临床上可以广泛推广。     

莱芜市大气环境颗粒物中多环芳烃污染状况调查

莱芜市位于鲁中山区，素有“钢城煤都”之称，近年来，随着工业化、城市化进程的加快，市区空气质量有所下降。莱芜市环境监测站历年环境质量检测数据显示，二氧化硫、二氧化碳污染相对严重。多环芳烃是一类普遍存在于环境中的难降解的“三致”有机污染物，因此受到广泛关注。     

精细化管理在医院门诊药房管理中的应用与实践

目的 研究精细化管理在医院门诊药房中的管理模式及应用实践.方法 根据医院门诊药房的特殊性制订医院门诊药房的精细化管理方案,在此基础上,考察医院门诊药房实施精细化管理后的效果.结果 建立起精细化的医院门诊药房管理方案,该方案实施后,每人日调剂量明显增加,平均侯药时间和单方调剂时间明显缩短,患者满意度由63.58％提高为89.30％,差异有统计学意义（P＜0.05）.结论 医院门诊药房管理精细化,能有效提高工作效率,优化药房人力资源,提高药房管理水平.     

家庭康复护理在痉挛型脑瘫患儿精细运动中应用

目的:探讨家庭康复护理配合按摩针灸、促通技术及作业疗法在痉挛型脑瘫患儿精细运动中的应用效果。方法:67例痉挛型脑瘫患儿随机分为干预组、对照组,对照组给予常规治疗,干预组配合家庭康复护理。结果:干预组精细运动能力提高优于对照组,2组比较差异有统计学意义。结论:家庭康复护理配合按摩针灸、促通技术及作业疗法,明显提高痉挛型脑瘫患儿精细运动功能。因此规范的康复治疗与正确的家庭康复护理,对脑瘫患儿的精细运动功能及日常生活能力提高,具有非常重要的作用。     

Diagnostic accuracy and safety of CT-guided fine needle aspiration biopsy in cavitary pulmonary lesions

Objective

CT-guided transthoracic biopsy is a well-established method in the cytologic or histologic diagnosis of pulmonary lesions. The knowledge of its diagnostic performance and complications for cavitary pulmonary lesions is limited. The purpose of this study was to determine the diagnostic accuracy and safety of CT-guided fine needle aspiration biopsy (FNAB) in cavitary pulmonary lesions.

Materials and methods

102 consecutive patients with pulmonary cavitary lesions received CT-guided FNAB with use of an 18-gauge (n = 35) or 20-gauge (n = 67) Chiba for histology diagnosis. The sensitivity, specificity, and diagnostic accuracy of FNAB were calculated as compared with the final diagnosis. Complications associated with FNAB were observed. The diagnostic accuracy and complications were compared between patients with different lesion sizes and different cavity wall thickness.

Results

The overall sensitivity, specificity, and accuracy of FNAB were 96.3%, 98.0%, and 96.1%, respectively. The sensitivity, specificity, and diagnosis accuracy in different lesion size (<2 cm vs ≥2 cm), or different cavity wall thickness (<5 mm vs ≥5 mm) were not different (P > 0.05; 0.235). More nondiagnostic sample was found in wall thickness <5 mm lesions (P = 0.017). Associated complications included pneumothorax in 9 (8.8%) patients and alveolar hemorrhage in 14 patients (13.7%) and hemoptysis in 1 patient (1%). No different rate of complications was found with regard to lesion size, wall thickness, length of the needle path and needle size (P > 0.05).

Conclusion

CT-guided FNAB can be effectively ad safely used for patients with pulmonary cavitary lesions.     

Consumption Pattern of Low Income Rural Households in Nigeria

Abstract

Information on consumption pattern and food preparation methods of Igbo people in rural Nigerian communities from 242 households in two different ecological zones showed these communities still adhered to traditional food habits that are related to socio-economic status, production, distribution, utilization and household size. Starchy staples were the main foods consumed by 100% of respondents, followed by cereals, legumes, fruits and vegetables (60–80%) which were eaten when in season. Occasionally fish or meat was consumed by 40–50% of respondents. Intake of protein-rich foods was limited by purchasing power and availability; carbonated beverages, tea and coffee were rarely consumed as elicited from the questionnaire. Food items such as milk, sugar and rice are considered essential commodities due to scarcity and cost. Meals are usually consumed two times a day. Only on weekends and festival occasions do meals exceed this number. Rice is washed twice or more before boiling; other food commodities are overcooked or cooked in large quantities of water; vegetables are chopped before washing and cooking; these are practices that tend to destroy nutrients. Parboiled vegetables or undercooked meat are infrequent and unpopular. Malnutrition and starvation resulting from food insecurity (no link between production, distribution and utilization) for the expanding rural population may never be closed if food distribution, utilization and consumption patterns of food producers are neglected.     

Correlation of Urinary 1-Hydroxypyrene and 2-Naphthol with Total Suspended Particulates in Ambient Air in Municipal Middle-School Students in Korea

The authors investigated Korean municipal middle school students to ascertain whether urinary 1-hydroxypyrene (1-OHP) and 2-naphthol–markers for polycyclic aromatic hydrocarbon (PAH) exposure–reflect PAHs in ambient air. The authors used the β-ray absorption method, which is an index of ambient-air PAH exposure, to collect total suspended participate (TSP) data. The authors measured urinary 1-OHP and 2-naphthol concentrations in 137 nonsmoking students in 4 municipal middle schools within 1 km of ambient air monitoring stations. The median concentrations of urinary 1-OHP and 2-naphthol in the study were 0.09 nmole/mol creatinine and 2.19 μmol/mol creatinine, respectively, and the geometric means were 0.10 nmole/mol creatinine and 2.47 μmol/mol creatinine, respectively. Urinary 1-OHP concentration did not correlate significantly with any TSP index. There were significant correlations between urinary 2-naphthol level and the daily mean TSP level calculated for 2 days before survey, for 1 day before survey, and for the day of survey. These data suggest that urinary 2-naphthol may be a good marker for inhalation exposure to PAHs in ambient air.     

医院收费票据精细化管理的现状与改进

分析了目前医院收费票据管理中的存在的主要问题;通过精细化管理来解决票据管理中存在的问题,以实现医院财务数据的真实可靠,确保医院财务活动合法、有序。     

细针穿刺细胞病理学在淋巴瘤诊断中的应用

目的 探讨细针穿刺细胞学（FNC）检测在淋巴瘤诊断方面应用的可行性.方法 选择临床怀疑淋巴瘤的患者72例,行FNC检测并切取活组织行组织学病理诊断,对细胞学形态和免疫细胞化学进行分析.结果 72例中61例经FNC诊断为淋巴瘤,其中58例经组织病理学诊断.细胞学诊断敏感度为89.2％（58/65）,特异度为57.1％（4/7）,准确率为86.1％（62/72）,阳性预测值为95.1％（58/61）,阴性预测值为36.4％（4/11）.结论 FNC病理检查对淋巴瘤诊断是有应用价值且易被临床接受的方法,结合流式细胞术、免疫组织化学、荧光原位杂交等技术可提高淋巴瘤诊断的精确性,使淋巴瘤分型成为可能.     

Sentinel Node Biopsy After Neoadjuvant Chemotherapy in Cytologically Proven Node-Positive Breast Cancer

IntroductionSeveral studies have assessed the feasibility of sentinel lymph node biopsy (SLNB) after NAC in patients with breast cancer, but diagnostic accuracy has varied. We prospectively evaluated the diagnostic accuracy of SLNB in detecting axillary lymph node (ALN) metastases after NAC in patients with cytologically proven positive nodes before chemotherapy.Patients and MethodsWe studied 95 breast cancer patients with cytologically proven positive nodes and a partial or complete clinical response to NAC in the breast lesions confirmed using magnetic resonance imaging. Patients then underwent SLNB followed by ALN dissection. The identification rate of sentinel lymph nodes (SLNs) and the false negative rate of nodal metastases were assessed. Subgroup analysis was conducted according to several clinical factors.ResultsSLNs were successfully identified in 81 (85.3%) of the 95 patients. Among these 81 patients, 51 (63.0%) had ALN metastases on final pathologic examination after NAC. Eight of the 51 patients with ALN metastases had negative results on SLNB (false negative rate, 15.7%). Univariate analysis indicated that the false negative rate was significantly lower only in the HER2-negative group (P = .003).ConclusionSLNB after NAC did not correctly predict the presence or absence of axillary node metastases in patients with breast cancer who had cytologically proven positive nodes before NAC. However, the diagnostic accuracy might be different in cancer subtypes, therapeutic effect of chemotherapy, or sentinel lymph node status after chemotherapy. Well-powered studies are needed to confirm diagnostic accuracy of SLNB after NAC according to subgroup in patients with breast cancer.