健康体检中彩超和钼靶联合诊断早期乳腺癌的意义

目的:探讨乳腺钼靶X片、高频彩超及其两者联合应用对提高健康体检者早期乳腺癌诊断的意义。方法:选择健康体检中发现或可疑乳腺癌后经手术病理证实为乳腺癌的136例女性患者,对其术前彩超及X线钼靶检查结果与病理结果进行对比分析。结果:高频彩超及X射线钼靶诊断符合率分别为82.35%(112/136)、81.62%(111/136),两者间差异无统计学意义(P0.05);高频彩超与X射线钼靶联合的诊断符合率为90.44%(123/136),与单纯超声或钼靶摄片相比,差异均有统计学意义(P0.05)。结论:彩色超声与X线钼靶联合应用可以提高诊断早期乳腺癌的灵敏度及准确性,降低乳腺癌的漏误诊率。     

钼靶X线与高频彩超对乳腺癌筛查的诊断价值

目的评价钼靶X线与高频彩超对乳腺癌筛查的诊断价值,以提高乳腺癌的检出率。方法对53例经手术病理证实的乳腺癌患者术前钼靶X线、高频彩超结果与病理结果进行对照分析。结果 （1）钼靶X线摄片及高频彩超诊断符合率分别为83.33%、80.18%,两者间差异无显著性意义（P〉0.05）;钼靶X线摄片与高频彩超联合的诊断符合率为96.5%,与单纯钼靶X线摄片或高频彩超相比,差异均有显著性意义（P〈0.05）。（2）钼靶X线与高频彩超显示乳腺癌的征象有毛刺肿块、微细钙化、肿瘤血管及多种不典型征象。（3）钼靶X线与高频彩超对微细钙化检出率分别为60.3%、33.7%。钼靶X线检出钙化型乳腺癌比高频彩超敏感（P〈0.05）。（4）高频超声对乳腺癌血流信号检出率为80.4%,其中53.6%见穿支血流;钼靶X线显示异常血管征为22.64%。高频超声检测血流信号明显优于X线钼靶（P〈0.01）。结论钼靶X线、高频彩超均可作为乳腺癌筛查诊断的首选方法之一,综合影像检查可明显提高诊断符合率。     

彩色多普勒超声在乳腺恶性肿瘤患者中的诊断价值

目的探讨彩色多普勒超声在乳腺恶性肿瘤患者中的诊断价值。方法选取我院乳腺科2011年1月-2014年11月收治的经穿刺或手术病理证实为乳腺恶性肿瘤的115例女性患者为研究对象。所有病例均行彩色多普勒超声和X线钼靶摄片检查,由两名高年资影像科医师阅片,与病理结果进行对照分析,比较两种检查方法的诊断符合率。结果二维超声检查诊断符合率为61.74%(71/115),彩色多普勒超声为85.22%(98/115),X线钼靶摄片为79.13%(91/115)。彩色多普勒超声诊断符合率显著高于二维超声(P0.05),与X线钼靶摄片比较差异无统计学意义(P0.05)。结论彩色多普勒超声有助于提高乳腺恶性肿瘤诊断的准确性。     

高频彩色多普勒超声和X线钼靶诊断乳腺恶性肿瘤的临床价值

目的比较高频彩色多普勒超声与乳腺X线钼靶对乳腺恶性肿瘤的诊断价值。方法分析经病理证实的227例乳腺癌的彩色多普勒超声、钼靶X线的诊断符合率,并与二者结合的诊断符合率相比较。结果彩色多普勒超声、钼靶X线的诊断符合率分别为82.4%,79.3%,两者间差异无统计学意义(P>0.05),两者结合的诊断符合率为90.3%,与单纯高频彩色多普勒超声或钼靶摄片对比差异有统计学意义(P<0.05)。结论彩色多普勒超声、钼靶X线诊断乳腺癌具有同等价值,二者结合可提高诊断符合率。     

乳腺钼靶X线和超声联合检查对临床触诊阴性的乳腺病灶诊断价值

目的探讨乳腺X线摄片和高频彩超检查对临床触诊阴性乳腺病灶的诊断价值。方法 108例女性术前临床乳腺触诊阴性乳腺(156个病灶)患者均经X线钼靶与超声检查定性诊断,分别与术后病理对照分析。结果 156个病灶中,乳腺恶性肿块定性诊断的灵敏性:X线钼靶为61.5%,超声为46.2%;两者结合诊断为88.5%。结论乳腺X线摄片和高频彩超联合检查对临床触诊阴性的乳腺癌能提高诊断率。     

联合应用高频彩超及钼靶数字化摄片在乳腺浸润性导管癌诊断的应用价值

目的:探讨联合应用高频彩超声及钼靶数字化摄片在乳腺浸润性导管癌诊断中的价值.方法:回顾性分析2015年3月-2016年4月49例我院乳腺外科收治并经术后病理确诊为乳腺浸润性导管癌的患者,比较性分析单独应用高频超声、钼靶数字化摄片以及两种方法联合应用对诊断乳腺浸润性导管癌的准确率,并比较两种方法对乳腺浸润性导管癌诊断的一致性.结果:单独应用高频超声、钼靶数字化摄片以及两种方法联合应用在诊断乳腺浸润性导管癌的准确率分别是81.63%(40/49)、77.55%(38/49)和91.84%(45/49).高频超声和钼靶数字化摄片对乳腺浸润性导管癌诊断的吻合系数к=-0.128.结论:联合应用高频彩超声及乳腺钼靶在乳腺浸润性导管癌诊断中有突出的应用价值.     

高频彩超与钼靶X线对乳腺肿块的诊断对比及联合应用价值

目的探讨彩超、钼靶X线及联合诊断对乳腺肿块的诊断及与病理诊断的符合情况.方法 选取在我院住院手术乳腺肿块病人215例,其中良性肿物138例,恶性肿物的77例,其超声声像图和钼靶X线的特点进行总结,与手术病理结果进行对比.结果 彩超检出乳腺良性肿块173例,恶性肿块42例;钼靶X线检出乳腺恶性肿块59例,良性肿块156例;病理诊断乳腺恶性肿块77例,良性肿块138例,彩超检查符合率%,钼靶X线符合率%.结论 彩超与病理结果符合率一般,钼靶X线与病理结果符合率一般,彩超及钼靶X线两者之间的差异无统计学意义,二者联合应用与病理结果符合度强,说明联合诊断高于单独彩超及钼靶X线诊断,可大大提高诊断率.     

高频彩色多普勒超声与X线钼靶对乳腺肿物诊断的临床价值

目的探讨高频彩色多普勒超声与X线钼靶对乳腺肿块的诊断价值及联合应用两种技术的互补性。方法对59例临床疑诊为乳腺肿物的患者均行高频彩超及X线钼靶检查,均与手术病理结果相对照。结果高频彩超对乳腺良性肿物诊断符合率为83.3%,对乳腺癌诊断符合率为82.4%。X线钼靶对乳腺良性肿物诊断符合率为52.4%,对乳腺癌诊断符合率为76.5%。结论高频彩超与X线钼靶对乳腺恶性肿物有相同的价值,而高频彩超对良性肿物的诊断率明显高于X线钼靶,并且在肿物定位及淋巴结转移的检出方面优于X线钼靶。而X线钼靶在微小钙化的检出方面优于高频彩超。而二者相结合,能提高早期乳腺癌的诊断率。     

彩超联合钼靶在乳腺普查中的应用价值

目的探讨彩超与钼靶X线联合应用在乳腺筛查中的应用价值。方法对3542人进行乳腺钼靶及彩超检查,并与病理诊断结果对照进行统计学分析。结果钼靶与病理诊断总符合率86.8%,彩超与病理诊断总符合率88.7%,两者差异无显著性（P〉0.05）。彩超结合钼靶的符合率为96.2%,与单钼靶及单彩超相比均别有显著性差异（P〈0.05）。结论临床触诊＋钼靶＋彩超的模式是目前进行乳腺普查的最佳模式。     

高频超声X线钼靶摄影和对乳腺癌的诊断价值

目的:探讨彩色多普勒超声、X线钼靶及两者联合应用对乳腺癌诊断的价值。方法:采用彩色多普勒超声和X线钼靶摄片检查对482例乳腺肿块进行诊断,并均经手术与病理学证实。结果:彩色多普勒超声、X线钼靶及两者联合应用诊断乳腺癌的符合率分别为88.4%(426/482)、89.0%(429/482)、92.3%(445/482)。结论:彩色多普勒超声与X线钼靶摄片联合应用较单一钼靶X线摄片诊断乳腺癌的敏感性强,对于提高乳腺癌的诊断符合率有一定实用价值。     

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.