超声诊断乳腺肿块性质的价值

目的:探讨彩色多普勒超声诊断乳腺肿块性质的价值。方法:应用彩色多普勒超声检查经手术和病理证实的肿块,其中良性肿块51例,恶性肿块25例。结果:①直径<2 cm的恶性肿块彩色血流信号检出率(100%)高于良性肿块(11.7%)。②直径≥2 cm的恶性肿块彩色血流信号检出率(93.6%)高于良性肿块(70.5%)。③当肿瘤直径<2 cm时,良恶性肿瘤之间的临界动脉峰值流速为12 cm/s,而静脉型血流频谱只在良性肿块内探及。结论:在直径<2 cm的乳腺肿块内探及血流信号以恶性可能性大,彩色多普勒血流显像检查,可以提高乳腺恶性肿瘤,特别是2 cm以下的乳癌的诊断率。     

彩色多普勒显像及微钙化灶的超声显示对乳腺肿块的评价

目的　探讨彩色多普勒显像及微钙化灶的超声显示对乳腺肿块鉴别诊断中的价值。方法　我们对 2 0 0 2 - 0 1～ 2 0 0 3- 0 6间经手术病理证实的 10 2例乳腺肿块超声扫查资料进行分析 ,重点讨论彩色多普勒血流及微钙化灶在不同大小良、恶性肿块内的显示状况。其中 ,恶性肿瘤 4 6例 ,良性肿块 5 6例。本组分别对不同病理类型乳腺肿块血流显示率、不同直径乳腺良、恶性肿块血流信号检出率及血流丰富程度、脉冲多普勒检测结果Vmax、RI值、不同直径良恶性肿块内微钙化灶超声显示情况进行对比分析。结果　不同病理类型乳腺肿块血流显示率无明显差别 ,乳腺恶性肿瘤血流信号检出率明显高于良性肿块 ,≤ 2cm乳腺恶性肿瘤血流信号检出率明显高于良性肿块 ,>2cm乳腺良、恶性肿块血流信号检出率无明显差异 ,恶性乳腺肿瘤较良性肿块血流信号丰富 ,乳腺恶性肿瘤呈高速高阻型 ,RI值偏高。乳腺良性肿块呈高速低阻型 ,RI值偏低 ,>2cm乳腺恶性肿瘤微钙化灶显示率明显高于良性肿块 ,<2cm良、恶性肿块微钙化灶显示率无明显差异。结论　二维声像图结合彩色多普勒和脉冲多普勒综合应用是诊断乳腺肿块的首选方法 ,对于≤ 2cm乳腺肿块 ,彩色多普勒血流显像在鉴别肿块良恶性有诊断价值 ,>2cm乳腺肿块微钙化灶的显示对乳癌有诊断价?     

彩色多普勒超声对乳腺良恶性肿块的诊断价值

目的:探讨彩色多普勒超声诊断乳腺良恶性肿块的价值。方法:对136例发现乳腺肿块的患者采用彩色多普勒超声进行检查,观察彩色多普勒声像图特征、血流信号检出率,并与手术病理结果进行对比。结果:脂肪瘤、炎性囊肿超声检出率100%,乳腺增生检出率93.3%,纤维腺瘤检出率95.2%,恶性肿瘤检出率92.5%;良性肿块大多界清,有包膜,形态规则,内部回声较均匀,后方无衰减,恶性肿块大多边界欠清或不清,无包膜,形态不规则,内部回声不均匀,后方有衰减;良性肿块血流信号分级以0～I级为主,恶性肿瘤以Ⅱ～Ⅲ级为主。结论:彩色多普勒超声对乳腺良、恶性肿块的形态学检查有重要鉴别诊断价值,但应注意二维声像图特征与彩色多普勒超声的血流动力学参数相结合,以减少误诊。     

彩色多普勒血流成像和频谱多普勒超声对乳腺良、恶性肿块的临床鉴别诊断价值

目的 探讨彩色多普勒血流成像和频谱多普勒超声对乳腺良、恶性肿块的诊断和鉴别诊断价值.方法 采用彩色多普勒检查224例乳腺肿块(良性120例,恶性124例),观察肿块内血管形态,数目与血流分布部位,获取滋养动脉血流频谱后,测定收缩期峰值流速(Vmax),最小舒张期流速(Vmin),阻力指数(RI)脉动指数(PI).结果 本组244例乳腺肿块中检出有血流信号者128例,检出率为52.45%,其中良性肿块22例,检出率18.33%,恶性肿块106例,检出率85.%.良性肿块组:阻力指数为(0.55±0.15);脉动指数为(1.18±0.17).恶性肿块组:阻力指数为(0.80±0.17);脉动指数为(1.78±0.46).两者间差异有统计学意义(P<0.01).结论 彩色多普勒血流成像与频谱多普勒超声能够提供乳腺良、恶性肿块的诊断和鉴别诊断的有限血流信息,可作为二维灰阶超声检查基础上的一种补充检查方法.     

彩色多普勒超声在乳腺肿瘤的诊断价值

目的：探讨彩色多普勒超声在乳腺肿瘤中的诊断价值。方法：采用彩色多普勒超声仪对78例乳腺肿块患者进行检查,观察肿块二维表现,评价彩色多普勒血流显像特征。结果：恶性肿瘤中72%肿块内探及微小钙化,肿块纵横比〉1.2者占74%;恶性肿瘤血流信号分布特征以Ⅱ级、Ⅲ级高于良性肿瘤,两者差异有显著性（P〈0.05）;恶性肿块收缩期峰值流速（PSV）及阻力指数（RI）值均高于良性,两者差异有显著性（P〈0.05）。结论：彩色多普勒超声诊断乳腺良恶性肿瘤有重要价值。     

彩色多普勒超声对乳腺肿块的诊断价值

目的:探讨高频超声对乳腺肿块的诊断价值。方法:应用彩色多普勒超声检测肿块大小、形态、边界、内部回声、纵横比,观察肿块内部及周边有无血流信号及其血流动力学表现。结果:与病理学检查结果对照,良、恶性肿块在二维声像图上,均有各自声像特征,在彩色多普勒检测中,83.3%(35/42)良性乳腺肿瘤内未探及血流,16.7%(7/42)在肿块周边测及少量血流,血流信号以Ⅰ级为主,血流阻力指数0.41～0.64。96.2%(25/26)恶性乳腺肿瘤肿块内可以探及血流信号,血流信号以Ⅱ～Ⅲ级为主,血流阻力指数0.66～0.91。结论:将肿块的二维声像图特征与血流动力学改变的综合性指标结合,有助于提高乳腺良恶性肿瘤诊断的准确率。     

彩色多普勒超声对乳腺肿块的诊断价值

目的 探讨二维超声及超声多普勒血流显像鉴别乳腺肿块的诊断价值.方法 对166个乳腺肿块进行超声检查,对比分析良、恶性肿块的二维超声特点、彩色血流情况及血流动力学参数的特征.结果 与病理学检查结果对照,良、恶性肿块在二维超声图像上均有各自声像特征,在彩色多普勒检测中,82.1% (96 /117)乳腺良性肿瘤内未探及血流信号,17.9% (21 /117) 在肿块周围测及少量血流信号,血流信号以Ⅰ级为主,血流阻力指数0.44-0.66,91.8% (45 /49)乳腺恶性肿瘤肿块内可以探及血流信号,血流信号以Ⅱ-Ⅲ级为主,血流阻力指数0.63-0.95.结论 彩色多普勒超声作为安全、无创的检查方法,对乳腺肿块的定性诊断准确性较高,可清晰显示肿块的二维声像图特点和血流特征,对乳腺肿块的鉴别均有重要临床应用价值.     

彩色多普勒超声在腮腺良恶性肿瘤鉴别中的应用

目的:探讨彩色多普勒血流显像(CDFI)、彩色多普勒能量图(CDE)在腮腺良恶性肿瘤鉴别中的作用。方法:用二维声像图(2DUS)、彩色多普勒血流显像、彩色多普勒能量图等超声方法检查腮腺肿瘤90例,按肿块的2DUS特征和血流特点判定为良性和恶性,检查结果与手术后病理对照,将同一肿块的CDFI与血流显示情况及其血流动力学指标进行对比分析。结果:CDFI显示恶性肿瘤的血流信号检出率高,良、恶性肿物的血流信号检出率分别为34.62%(18/52)、81.58%(31/38)。CDE显示恶性肿瘤的血流信号更丰富,两者有显著性差异。结论:彩色多普勒超声在腮腺良恶性肿瘤诊断中具有重要的价值。     

78例乳腺肿块的彩色多普勒超声分析

目的 :探讨彩色多普勒超声检查乳腺肿块的诊断价值。方法 :收集我院 1998年 9月至 2 0 0 0年 3月间经彩色多普勒超声检查的 78例乳腺肿块患者 ,其中良性 45例 ,恶性 33例 ,均经手术和病理证实。采用美国DIASONICS -GATEWAYfX双功能超声仪 ,先观察乳腺肿块二维声像图 ,再用彩色血流显像观察肿块内及周边血流情况 ,并给予量化。结果显示 :恶性组血流检出率明显高于良性组 (P <0 .0 1) ,恶性组血流速度显著高于良性组 (P <0 .0 1) .结论 :因少部分良恶性肿块血流有相似之处 ,故应充分结合二维声像图才能更准确诊断。     

彩色多谱勒超声对乳腺肿块的诊断价值

目的:探讨彩色多普勒超声对乳腺良、恶性肿块的诊断价值。方法:对150例乳腺肿块患者进行彩色多普勒超声检查,观察肿块的边缘轮廓、包膜、后方回声,肿块内部回声及有无钙化,随后常规扫查双侧腋下淋巴结有无肿大。CDFI:观察肿块内血流分级、流速、阻力指数情况。结果:150例患者进行彩色多普勒检查后,良性患者87例,恶性患者63例,良、恶性肿块内血流检出率:良性为6.89%,恶性为88.8%。结论:彩色多普勒超声对乳腺肿块的检查经济、简便易行、无创伤,是降低乳腺恶性肿块误诊率、提高其诊断正确性的重要手段之一。     

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.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

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.