沭阳县民营乡镇医院群众满意度调查与分析

在2010年7~9月调查了沭阳县38家乡镇医院中有就诊经历的群众,采取现场问卷调查的方式调查与分析沭阳县乡镇群众对医院满意度,了解沭阳县民营乡镇医院的医疗服务质量以及民营医院在群众中的形象?在各项满意度得分中,舒适性得分最高,其次为方便性和安全性,经济性得分最低?乡镇医院要找准自身定位,做好发展规划;打造诚信品牌,加强医德医风建设;提高诊疗水平;加强成本核算与控制,不断降低医疗费用?     

超声造影联合血清CA125检测在卵巢肿块良恶性鉴别诊断中的初步应用

目的探讨超声造影联合血清CA125检测在卵巢肿块良恶性鉴别诊断中的应用价值.方法回顾性分析49个卵巢肿块的彩色多普勒、超声造影表现以及血清CA125检测水平,并与临床诊断结果进行对照.结果 49个卵巢肿块中,彩色多普勒超声检查判断肿块良恶性的准确率、敏感度和特异度分别为67.35%(33/49)、70.00%和63.16%,超声造影检查判断卵巢肿块良恶性的准确率、敏感度和特异度分别为85.71%(42/49)、86.67%和84.21%,超声造影检查联合血清CA125检测判断卵巢肿块良恶性的准确率、敏感度和特异度分别为97.96%(48/49)、100.00%和94.74%.3种检查方法的诊断准确率、敏感度和特异度的差异均有统计学意义(P值均<0.05).结论超声造影检查能显示卵巢肿块内微小血管的血流灌注和血管形态,超声造影检查结合血清CA125检测能进一步提高对卵巢肿块良恶性的鉴别诊断价值.     

19例骶尾部肿块的超声声像图分析

目的 回顾性分析19例骶尾部肿块的超声声像图特征,旨在提高超声诊断的准确性.方法 对19例骶尾部肿块的超声声像图表现与病理进行对比分析.结果 19例患者中7例病理诊断为脂肪瘤,占37%,5例为皮脂腺囊肿,占26%,2例肌纤维瘤,占11%,2例神经鞘瘤,占11%,1例脊索瘤,占5%,1例脑脊膜膨出,占5%,1例外伤后血肿,占5%,超声诊断与病理诊断符合率95%.结论 超声声像图根据骶尾部肿块的解剖位置,形态,内部回声及血流情况,可初步判断其性质,为临床提供了必要的诊断信息.     

Screening for breast cancer with mammography

Mammography is generally accepted as a useful problem-solving clinical tool in characterizing known breast lesions, so that appropriate and timely treatment can be given. However, it remains grossly underutilized at what it does best: screening. The major strengths of mammography are a) its ability to detect breast cancer at a smaller, potentially more curable stage than any other examination, and b) its proved efficacy in reducing breast cancer mortality in asymptomatic women aged 40–74. If, as has recently been estimated, screening with mammography and physical examination can be expected to lower breast cancer deaths by 40%–50% among those actually examined (13), then the lives of almost 20,000 U.S. women might be saved each year if screening were to become very widely used. The challenges of the next decade are clear, to mount much more effective campaigns to educate physicians and lay women about the life-saving benefits of breast cancer screening, to devise increasingly effective and lower cost screening strategies, to further improve the current high quality of mammographic imaging despite its increasing proliferation, and to train large numbers of breast imaging specialists to guarantee that the growing case load of screening and problem-solving mammograms is interpreted with a very high level of skill.     

New applications of pelvic sonography

This review discusses and illustrates the many applications of transvaginal sonography in gynecology. TVS has improved the accuracy of evaluation of pelvic masses and affords a means for accurate guided aspiration. The accuracy of follicular monitoring and aspiration is also enhanced with transvaginal sonography. The possible applications of transvaginal sonography as a means for screening for early ovarian carcinoma is also discussed as well as applications involving evaluation of the uterus and endometrium.     

CT引导下经皮穿刺活检对纵隔占位病变的诊断价值

目的评价CT引导下经皮穿刺活检术在纵隔占位病变中的应用价值和安全性。方法采用弹簧式自动活检枪,在CT精确定位下对纵隔内占位病变行经皮穿刺活检,所获标本送病理组织学检查,并对穿刺准确性、病理确诊率和并发症发生情况进行分析。结果本组33例病灶穿刺成功率100%,病理确诊率85%,无一例发生并发症。结论CT引导下经皮穿刺活检术是一项操作方便,定位精确,穿刺准确率和病理确诊率高,安全可靠的介入放射诊断技术,对纵隔占位病变的定性诊断很有价值,值得临床推广应用。     

彩色多普勒超声诊断乳腺肿块的价值

目的:探讨彩色多普勒超声诊断良恶性乳腺肿块的价值,旨在提高诊断水平。方法:应用彩色多普勒超声,诊断乳腺肿块81例,所有病例均经临床、手术及病理证实。结果:多普勒超声对乳腺肿块显示率为100%,诊断出其中恶性肿块9例,良性肿块67例,诊断准确率达93.8%。结论:彩色多普勒超声诊断乳腺肿块应以声像图为基础,密切观察肿块的血流信号,同时结合临床病史资料,具有较高的诊断价值。     

纵隔低密度肿块病变CT诊断

目的：提高纵隔低密度肿块病变ＣＴ诊断水平。材料与方法：回顾性分析５１例经临床、手术及病理确诊纵隔低密度肿块变的ＣＴ表现。结果：（１）不同纵隔低密度肿块病变均有其较特定的发病部位;（２）含脂肪密度肿块病变包括囊性畸胎瘤,脂肪瘤 低密度肿块为包括囊性淋巴管瘤,胸腺囊肿,支气管囊肿,心包囊肿,神经纤维瘤囊性变,囊性畸胎瘤,椎旁脓肿;（４）含气及水样密度肿块包括食管癌术后胸腔内胃,食管憩室;（５）２例胸腺     

Role of fine-needle aspiration biopsy in the assessment of renal masses

Clinical and histological control of fine-needle aspiration biopsy (FNAB) diagnosis of 72 kidney masses observed between 1981 and 1988 confirmed 34 benign and 33 malignant lesions, but did not confirm four malignant and one benign lesions, giving a total diagnostic accuracy of 93.05%. The role of FNAB in selecting cases to be sent to surgery was investigated by comparing the incidence of useful surgery (for benign and primary malignant neoplasias) and the incidence of useless surgery (for nonneoplastic lesions and secondary malignant neoplasias) in nephrectomized patients who either had (group A, 27 patients) or didn't have (group B, 198 patients) preoperative FNAB. The differences were highly significant (P less than 0.001). Furthermore, patients operated for malignant neoplasias (20 in group A; 117 in group B) displayed highly significant differences (P less than 0.001) with respect to renal vein infiltration (1 in group A versus 22 in group B) and local-regional lymph node metastases (1 in group A versus 15 in group B). In conclusion, FNAB is a reliable method for selecting cases for surgery and for aiding in the diagnosis of malignant neoplasias.     

布氏显微镜活血分析: 细胞流变学研究的新方法

布氏显微镜活血分析：细胞流变学研究的新方法骆秉铨＊黄荣国＊陈兴新＊细胞流变学是研究血细胞流动变形的科学，在方法学上发展了一些比较成熟的方法，但多不能直接动态观察细胞水平的真实改变，有待完善和创新。我们采用布氏多功能显微镜的活血分析法［１］，在高放大倍...