二维及彩色多普勒诊断乳腺肿块的临床应用

目的　分析良恶性乳腺肿块二维声像图特征和彩色多普勒血流状况并分别与病理对照。方法　 78例乳腺肿块经二维超声了解其形态、边界、边缘、纵横比、内部回声、有无后方衰减及侧方声影等 ,然后用彩色多普勒检查 ,观察肿块内部及周边血流情况。结果　乳腺肿块分布依次为外上 >内上 >外下 >内下象限。二维声像图最重要的特征是 ,边界回声。良性肿块多表现为边界光滑 ,这与其呈膨胀性生长有完整包膜有关 ;而恶性肿瘤表现为肿块前、侧缘有不规则强回声 ,这与癌组织侵润和周围纤维组织增生有关。同时彩色多普勒检出的血流信号丰富与否也是关键 ,恶性肿瘤均可检出丰富血流信号。结论　二维及彩色多普勒诊断乳腺良恶性肿块 ,对照病理符合率较高 ,具有非常有用的临床应用价值     

乳腺肿块彩超显像与病理对照分析

目的探讨乳腺良、恶性肿块二维声像图和彩色多普勒血流显像情况。方法74例乳腺肿块患者经二维超声了解其形态、边界、内部回声、有无后方衰减及侧方声影等，然后用彩色多普勒检查，观察肿块内部及周边血流情况，并与病理结果进行对照。结果乳腺肿块的超声诊断与病理诊断的符合率为95．9％。大多数恶性肿块形态不规则，边界不清，内部回声不均匀，同时彩色多普勒检出丰富的血流信号；良性肿块多表现为边界光滑，侧缘回声减弱，这与良性肿块呈膨胀性生长，有完整包膜有关。结论在乳腺肿块的诊断中，以边界回声特征最为重要，它是良、恶性肿块鉴别的关键；二维声像图及彩色多普勒诊断乳腺良、恶性肿瘤，符合率较高，具有较大的临床应用价值。     

乳腺肿块的超声诊断

目的回顾性分析经手术病理证实的455例乳腺肿块的声像图特征和彩色多普勒特点，以提高乳腺肿瘤超声定性诊断的符合率。方法对乳腺肿块进行二维超声检查，了解其形态、边界、边缘、内部回声、有无后方衰减及侧方声影等，然后进行彩色多普勒血流检查，观察肿块内部及周边血流情况，并分别与病理结果对照。结果在乳腺肿块声像图诊断中，以肿块边界回声特征最为重要，它是肿块良、恶性鉴别的关键。本文92．65％恶性肿块形态不规则，边界不清，内部回声不均匀，肿块前、侧缘有不规则强回声，同时彩色多普勒检出丰富血流信号。良性肿瘤多表现为边界光滑，侧缘回声减弱，彩色多普勒不能检出或检出少量星点状血流信号。结论超声声像图及彩色多普勒特征，对乳腺肿瘤性质的的判断有较大的临床应用价值。     

二维及彩色多普勒超声对乳腺肿块的诊断价值

目的:分析乳腺良、恶性肿块的二维声像图及彩色血流特点,提高乳腺肿瘤的超声诊断率.方法:回顾性分析135例经手术病理证实的乳腺肿块声像图特点及彩色血流分布情况,同时进行了彩色多普勒血流检测.结果:良、恶性乳腺肿瘤的声像图表现有明显差异,主要表现为形态、边界、内部回声、后方声衰减及钙化灶有无等方面.恶性肿瘤的纵横比多大于0.8cm.彩色多普勒探测恶性肿瘤内部具有丰富的高速动脉血流,检出率明显较良性肿瘤高.结论:二维声像图与彩色多普勒紧密相结合进行分析,可提高乳腺肿瘤的定性诊断的敏感性和特异性.     

彩超在乳腺肿瘤临床诊断中的应用分析

目的深入分析在乳腺肿瘤诊断中彩色多普勒超声诊断仪的应用。方法回顾分析320例乳腺肿瘤患者在二维和彩色多普勒血流显像模式下,观察患者乳房肿瘤声像图特征及其内部和周围彩色血流情况。结果经过超声检测诊断320例患者中,良性乳腺肿块为278例,并详细比对了恶性乳腺肿块与良性乳腺肿块的边界、内部回声、病灶形态等,以肿瘤边界回声特征最为重要,它是肿瘤良、恶性鉴别的关键。本文大多数恶性肿瘤形态不规则,边界不清,内部回声不均匀,肿瘤前、侧缘有不规则强回声,同时彩色多普勒检出丰富学流信号。良性肿瘤多表现为边界光滑,侧缘回声减弱,彩色多普勒不能检出或检出少量星点状血流信号。其中有12例为误诊病例。结论采用彩超测定乳腺肿瘤,分析肿瘤的边界、形态、内部回声及彩色多普勒血流特征,这样有助于检出是否患有乳腺肿瘤并有助于乳腺肿瘤良、恶性的鉴别。     

二维及彩色多普勒超声诊断乳腺肿块的临床价值

目的 探讨二维及彩色多普勒超声诊断乳腺良恶性肿块的临床应用价值。方法 对56例经手术病理证实的乳腺肿块的二维及彩色多普勒声像图的表现与病理结果进行回顾性对比分析。结果 大多数恶性肿块形态不规则,边界不清晰,内部回声不均,同时恶性肿块彩色多普勒血流检出率及阻力指数(RI)均高于良性肿瘤。良性肿块多表现为边界光滑,内部回声均匀。结论 二维及彩色多普勒超声诊断乳腺良恶性肿块符合率较高,具有较大的临床应用价值。     

甲状腺肿块二维及彩色多普勒212例诊断分析

目的探讨甲状腺肿块二维声像图和彩色多普勒血流状况.方法212例甲状腺肿块经二维超声检查,了解其形态、边界、内部回声;然后用彩色多普勒检查,观察肿块内部及周边血流情况.并与手术后或穿刺细胞学检查结果对照分析.结果在甲状腺肿块声像图诊断中,以内部回声及边界回声特征最为重要,它是肿块良、恶性鉴别的关键.本组15例恶性肿块形态不规则、边界不清、内部回声不均,同时彩色多普勒检出丰富血流信号、RI＜0.5;良性肿瘤多表现为边界光滑,这与良性肿瘤呈膨胀性生长有关.结论二维及彩色多普勒诊断甲状腺肿块符合率较高,具有较大的临床应用价值.     

二维及彩色多普勒超声对乳腺肿块的诊断价值

目的:分析乳腺肿块的二维声像图和彩色多普勒血流显像特征与其相关的病理特点,探讨其对乳腺肿块的诊断价值。方法:对65例经手术病理证实的乳腺肿块的二维及彩色多普勒声像图表现进行回顾性对比分析。结果:恶性肿块呈形态不规则,内部回声不均,边界不清晰,呈毛刺状或蟹足状改变,内部多见微小钙化点;良性肿块多表现为形态规则,边界光滑,内部回声均匀。乳腺恶性肿块彩色多普勒血流检出率及阻力指数均高于良性肿块。结论:二维超声结合彩色多普勒血流检查诊断乳腺良恶性肿块正确率较高,具有较高的临床应用价值。     

50例甲状腺癌的彩色多普勒超声诊断

目的:回顾性分析经手术病理证实的50例甲状腺肿物的声像图特征和彩色多普勒特点,以提高甲状腺肿物超声定性诊断的符合率。方法:对甲状腺肿物进行二维超声检查,了解其形态、边界、边缘、内部回声、有无后液化及钙化等,然后进行了彩色多普勒血流检查,观察肿块内部及周边血流情况,并分别与病理结果对照。结果:在甲状腺肿物声像图诊断中,以肿物边界回声特征最为重要,它是肿物良、恶性鉴别的关键。本文大多数恶性肿物形态不规则,边界不清,内部回声不均匀,回声减低,同时彩色多普勒检出丰富血流信号。良性肿瘤多表现为边界清,回声均匀,彩色多普勒少量点状血流信号或无血流信号。结论:超声声像图及彩色多普勒特征,对甲状腺肿物性质的判断有较大的临床应用价值。     

彩色多普勒与二维超声诊断乳腺肿块的声像图特征与病理对照分析

目的观察彩色多普勒与二维超声诊断乳腺肿块的声像图特征,并与临床病理作对照。方法应用彩色多普勒与二维超声诊断100例乳腺肿块,并对其声像图及病理结果做总结分析。结果乳腺良恶性肿块的二维声像图特征、CDFI血流信号分级及血流动力学指标比较,各具特征性,且差异有统计学意义（P〈0．05）。结论彩色多普勒与二维超声诊断乳腺肿块不仅能够观察肿块的边界、内部回声及血流分布情况,还可以定量提供血流动力学指标的变化情况,明显提高诊断的准确率,值得推广。     

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.     

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.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.