乳腺高频钼靶X线检查对妇女乳腺肿瘤和乳腺增生症的诊断价值

目的探讨乳腺高频钼靶X线检查对乳腺疾病特别是对乳腺症和乳腺肿瘤诊断的可靠性和有效性。方法通过对2524例乳腺疾病患者使用意大利产高频钼靶X线机,对两侧乳房常规拍摄标准为：头尾位（CC）和内、外侧斜位（MLO）。结果2362例均有不同程度的乳腺增生,（93．6％）,16例重度增生（0．6％）,44例良性纤维腺瘤（1．7％）,46例乳腺癌（1．8％）,56例正常（2．2％）。结论乳腺高频钼靶X线检查对妇女乳腺肿瘤和乳腺增生症的诊断价值较高。乳腺高频钼靶X线检查方便,患者无痛苦,无损害,图像清晰,检出率高,诊断准确,是诊断乳腺疾病的最有效检查方法。同时,为了做到乳腺癌的早期发现,早期治疗,根据国内外对乳腺癌普查的经验认为：乳腺X线钼靶检查可用于35岁以上的妇女普查,50岁以上的妇女应每年摄片一次,40～49岁的妇女1～2年摄片一次。     

CR乳腺钼靶X线检查的临床应用

[目的]讨CR(计算机X摄影)成像系统在乳腺钼靶摄影中的优越性及其临床应用价值.[方法]97例乳腺病女性患者应用高频钼铑双靶乳腺机及CR系统进行计算机乳腺摄影检查,并比较图像质量及X线诊断正确率.[结果]CR乳腺钼靶X线摄影照片中甲片率为68.6%,明显优于普通铝靶乳腺X线摄影(MO)组(39.1%),两组比较差异有显著性(P<0.05),且CR乳腺钼靶X线摄影照片的废片率为零.此外,CR乳腺钼靶X线诊断的正确率为91.4%,显著优于MO(77.8%).[结论]CR成像系统实现了乳腺X线检查的数字化摄片,为乳腺疾病的诊断提供高质量的图像,并提高了X线诊断正确率,对乳腺癌尤其早期乳腺癌的发现及诊断有重大价值.     

选择性斜位单相法钼靶X线在临床早期乳腺癌筛查中的价值

目的:①探讨选择性斜位钼靶单相法X线检查在临床早期乳腺癌筛查中的价值;②分析筛查中乳腺触诊+高频B超及/或斜位单相法钼靶X线检查对乳腺癌诊断的敏感度。方法:采用复合式乳腺健康调查问卷,对触诊异常者加做乳腺高频B超;对B超异常及40岁以上高危人群加做斜位单相法钼靶X线检查;对在2006~2008年妇女乳腺癌筛查中确诊的56例乳腺癌及46例临床早期乳腺癌患者的数据进行统计分析。结果:临床早期乳腺癌的诊断率为82.14%;对临床早期乳腺癌诊断的敏感度①触诊+斜位单相法钼靶X线检查为87.50%;②触诊+斜位单相法钼靶X线+乳腺高频B超为92.56%;③触诊+乳腺高频B超为72.72%。触诊+斜位单相法钼靶X线与触诊+斜位单相法钼靶X线+乳腺高频B超比较,P>0.05,差异无统计学意义;⑤触诊+乳腺高频B超与触诊+斜位单相法钼靶X线比较,P<0.05,差异有统计学意义。结论:①选择性斜位单相法钼靶X线检查是提高群体乳腺癌临床早期诊断率的关键。②触诊+斜位单相法钼靶X线+乳腺高频B超对临床早期乳腺癌诊断的敏感度明显高于触诊+乳腺高频B超,适用于临床早期乳腺癌的筛查。     

DWI-MRI联合X线钼靶对乳腺疾病的诊断价值研究

目的:探究核磁共振弥散加权成像(DWI-MRI)联合X线钼靶对乳腺疾病的诊断价值。方法:选取2018年5月~2019年3月我院接收的乳腺疾病患者90例,所有患者均接受DWI-MRI、X线钼靶单项和联合诊断,以临床最终诊断结果为金标准,对比DWIMRI、X线钼靶单项诊断与联合诊断的结果,分析单独诊断与联合诊断的诊断价值。结果:DWI-MRI、X线钼靶联合检查乳腺癌检出率(67.78%)分别高于DWI-MRI检出率(53.33%)、X线钼靶检出率(45.56%),差异具有统计学意义(P<0.05);联合检查灵敏度、特异性、准确度均高于单项检查,差异具有统计学意义(P<0.05)。结论:DWI-MRI联合X线钼靶诊断乳腺疾病效果好于DWI-MRI、X线钼靶单项诊断,利于提高恶性乳腺疾病的诊断准确率,临床建议使用。     

乳腺疾病的X线钼靶与MRI表现对照研究

目的 分析乳腺疾病的X线钼靶摄片与核磁共振成像(Magnetic Resonance Imaging,MRI)影像学表现,评价X线钼靶与MRI对乳腺疾病的诊断价值.方法 回顾性分析了67例乳腺疾病的X线钼靶与MRI表现.MRI分别采用脂肪抑制T2WI轴位扫描及动态增强减影扫描,X线钼靶采用常规方法摄片.结果 MRI诊断准确率为89.5％(60例),X线钼靶诊断准确率为77.6％(52例),均与病理结果相符.两者差异具有统计学意义(x2=7.83,P＜0.05).结论 钼靶乳腺摄影操作简单,检查费用较低,是筛查乳腺肿瘤首选的检查方法;MRI对乳腺疾病的诊断符合率明显高于X线钼靶,对乳腺疾病的治疗提供了重要依据.     

钼靶X线与高频彩超诊断乳腺肿块的价值

目的探讨钼靶X线与高频彩超对乳腺肿块的诊断价值。方法回顾性分析91例经病理证实的乳腺肿块患者的钼靶X线及高频彩超资料,分析钼靶X线及高频彩超对乳腺肿块的诊断能力。结果钼靶X线和高频彩超对91例乳腺肿块的检出率分别为:86.8%、84.6%,二者联合检出率为92.3%;对38例乳腺癌的检出率分别为89.5%、78.9%,诊断符合率分别为88.2%、86.7%。结论钼靶X线及高频彩超在发现和诊断乳腺肿块上均具有重要价值,两者结合可进一步提高乳腺肿块的检出率和诊断的准确率。     

钼靶及高频超声对浆细胞性乳腺炎的诊断特点

目的 利用钼靶及高频超声对浆细胞性乳腺炎影像特征进行分析,来降低其误诊率.方法 47例浆细胞性乳腺炎均为经产、非哺乳期妇女.年龄28～73岁,平均年龄39岁.发病均为单侧,同时采用芬兰乳腺X线机,常规拍摄双侧乳腺斜位(MRO)和轴位(CC)及彩色多普勒超声成像检查并与病理结果进行对照.结果 47例浆细胞性乳腺炎以乳腺肿块为首发症状者12例;乳头溢液10例;乳头内陷或变形者8例;皮肤局限性凹陷(酒窝征)7例;伴有腋下淋巴结肿大者10例.X线表现直接征象13例;间接征象34例;B型超声表现17例为腺体内导管扩张;彩色多普勒7例浆细胞性乳腺炎的"包块"内均有血流信号.结论 联合应用钼靶X线摄影及高频超声成像检查可提高对浆细胞性乳腺炎的诊断准确率.     

乳腺常见疾病的钼靶X线诊断价值

目的 探讨乳腺癌,乳腺增生病,乳腺纤维腺瘤三大乳腺疾病的钼靶X线征象及其诊断价值.方法 回顾性分析82例乳腺常见疾病钼靶X线检查资料,并与手术病理结果对照.结果 本组82例病例中,乳腺癌占29.27%,X线诊断准确率为79.17%;良性肿瘤占17.07%,X线诊断准确率为57.14%;乳腺增生病占48.78%,X线诊断准确率为77.5%.结论 大多数典型病例均能通过钼靶X线作出正确诊断,不典型者则需要结合其他临床检查以及病理检查进行确诊.     

160例早期乳腺癌患者高频超声与钼钯X线诊断结果分析

目的探讨高频超声与钼靶X线诊断早期乳腺癌的临床价值,为临床提供依据。方法选择2015年1月-2016年12月在河北工程大学附属医院体检且高度怀疑乳腺癌的160例患者为研究对象,所有对象均行高频超声检查与钼靶X线检查。以术后病理结果为基准计算高频超声、钼靶、联合诊断的敏感度、特异度、阳性预测值、阴性预测值、准确性及微小钙化灶检出率。结果 160例受检者中,病理结果提示148例恶性病变,12例良性病变,154例可见微小钙化灶。高频超声的敏感度、准确率分别为89.86%、89.38%,均高于钼靶(P0.05)。联合诊断的敏感度、准确率、阴性预测值分别为95.95%、95.63%、64.71%,高于高频超声与钼靶X线(均P0.05)。高频超声的微小钙化灶检出率为79.87%,低于钼靶X线的91.56%(P0.05)。结论在乳腺癌的诊断中,建议初诊患者先行高频超声检查,必要时联合乳腺钼靶X线以提高早期乳腺癌诊断的准确性。     

乳腺钼靶X线摄影检查联合磁共振成像诊断乳腺导管原位癌的有效性

目的探究应用磁共振成像(magnetic resonance image,MRI)联合乳腺钼靶X线摄影检查诊断乳腺导管原位癌(ductal carcinoma in situ,DCIS)的临床价值。方法选择2014年10月至2016年8月深圳市龙华区中心医院确诊的105例DCIS患者,对其分别行MRI检查和乳腺钼靶X线摄影检查,后经手术病理确诊,观察MRI检查联合乳腺钼靶X线摄影和MRI单一诊断乳腺DCIS的临床价值与满意度。结果 105例乳腺DCIS患者应用MRI联合乳腺钼靶X线摄影检查的敏感度、特异度和准确度分别为91.38%、89.36%和90.48%,明显优于采用单一MRI诊断(57.41%、47.06%和52.38%),差异有统计学意义(P0.05)。结论针对乳腺DCIS患者选择应用MRI联合乳腺钼靶X线摄影检查可提高诊断效能,有利于疾病的早期诊治。     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

The occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.