声触诊组织成像面积比法与声触诊组织量化技术对BI-RADS 4类乳腺肿块的鉴别诊断价值

目的 ：探讨声触诊组织成像（VTI）面积比法与声触诊组织量化（VTQ）技术在乳腺影像报告与数据系统（BI-RADS4类乳腺肿块鉴别诊断中的应用价值。方法：应用声脉冲辐射力成像（ARFI）对68例女性患者76个经常规超声诊断为BI-RADS4类的乳腺肿块行VTI与VTQ检测,获得肿块VTI弹性图、肿块内部VTQ值,计算病灶VTI图与灰阶图面积比（VTI面积比）。以病理结果为金标准,绘制ROC曲线,找出VTI面积比和VTQ值诊断乳腺BI-RADS 4类恶性肿块的截断值。结果：BI-RADS4类乳腺恶性肿块的VTI面积比大于良性组,差异有统计学意义（P<0.001）。以VTI面积比1.56为截断值,诊断BI-RADS 4类恶性肿块的敏感度为81.6%,特异度为90.2%;肿块内部VTQ值的截断值为3.75 m/s,敏感度为77.1%,特异度为87.8%。2种诊断方法的AUC比较,差异无统计学意义（Z=0.391,P> 0.05）。结论：VTI面积比法与VTQ技术对BI-RADS 4类乳腺肿块的良恶性鉴别诊断均有较高的应用价值,两者诊断效能无明显差异。     

超声血流定量参数联合弹性成像鉴别诊断BI-RADS 3～4类乳腺良恶性肿块的诊断价值

目的 探究血流相关参数联合超声弹性成像（ultrasonic elastography,UE）鉴别诊断乳腺影像报告和数据系统分级（breast imaging reporting and data system,BI-RADS）3～4类乳腺良恶性肿块的诊断价值。方法 回顾性分析2021年1月-2022年8月以“乳腺肿块”就诊于淮南市第一人民医院并通过常规超声证实为BI-RADS 3～4类肿块的104例患者的资料,患者均行彩色多普勒超声与超声弹性成像检查,根据病理结果分为良性组41例和恶性组63例,比较两组超声血流分级情况、超声血流参数值[搏动指数（pulsatility index,PI）、收缩期峰值血流速度（peak systolic velocity,PSV）、阻力指数（resistance index,RI）]、UE相关参数（长径、长径变化率、面积、面积比值）、通过受试者特征曲线（receiver operating characteristic curve,ROC）评估超声血流参数值联合UE相关参数值鉴别诊断BIRADS 3～4类乳腺良恶性肿块的价值。结果 恶性组患者超声血流0...     

超声弹性成像联合乳腺X线摄影对BI-RADS 3～4类乳腺肿块诊断价值

目的 探讨超声弹性成像（UE）联合乳腺X线摄影对BI-RADS 3～4类乳腺肿块的定性诊断价值。方法 选取我院收治的BI-RADS 3～4类乳腺肿块患者80例（105枚病灶）的UE及乳腺X线摄影检查资料,绘制ROC曲线并分析两种方法联合检测对BI-RADS 3～4类乳腺肿块临床效果。结果 经术后病理证实80例患者（105枚病灶）病灶中良性73枚,恶性32枚。常规超声结果显示：105枚乳腺病灶中,3类病灶38枚,4A类病灶20枚,4B类病灶25枚,4C类病灶22枚。UE评分<4分的共66枚,诊断为良性病灶。UE评分≥4分的共39枚,诊断为恶性病灶。乳腺X线摄影诊断为良性病灶70枚,恶性病灶35枚,以病理诊断结果为金标准,两者诊断敏感性、特异性及准确率分别为：78.1%、80.8%、80.0%和68.8%、82.2%、78.1%。UE的ROC曲线下面积为0.801(95%CI:0.705～0.897),P=0.000。乳腺X线摄影ROC曲线下面积为0.782(95%CI:0.688～0.876),P=0.000。UE联合乳腺X线摄影后,重新调整BI-RADS分类,得出最佳诊断截点为4...     

弹性应变率比值联合BI-RADS对乳腺小肿块良恶性的鉴别诊断价值

目的 :探讨弹性应变率比值(SR)联合BI-RADS对乳腺小肿块的诊断价值,旨在提高该病的诊断水平。方法 :回顾性分析200例(390个小肿块,直径≤15 mm)乳腺肿块患者的超声BI-RADS分类和SR,并与手术病理结果进行比较。通过构建ROC,分析SR联合BI-RADS对乳腺小肿块良恶性的鉴别诊断能力。结果:390个小肿块中,良性237个,恶性153个;良性肿块的SR显著低于恶性肿块(P0.05);SR联合BI-RADS诊断乳腺微小病灶的灵敏度、阴性预测值及ROC曲线下面积均显著高于单用SR、BI-RADS分类(均P0.05)。结论 :SR联合BI-RADS可提高对直径≤15 mm乳腺小肿块恶性风险的评估能力及诊断准确性。     

超声造影联合弹性成像对BI-RADS 4类乳腺肿块的诊断价值

目的探讨超声造影(CEUS)联合弹性成像(UE)对BI-RADS 4类乳腺病灶的诊断价值。方法回顾性分析经手术病理证实的190枚BI-RADS 4类病灶的UE及CEUS声像图特点,以手术病理结果为"金标准",采用受试者工作特征(ROC)曲线分别评估两者单独及联合应用调整BI-RADS分类的诊断效能。结果 190枚病灶,病理结果显示良性71枚,恶性119枚。CEUS各增强特点良恶性组间差异均有统计学意义。CEUS、UE及常规超声的受试者工作特征曲线下面积(AUROC)分别为0.848,0.767,0.818,均小于UE联合CEUS调整BI-RADS分类的方法(AUROC为0.935),诊断效能具有统计学意义(P0.01)。常规超声、UE、CEUS的敏感度、特异度、准确率分别为97.5%,67.6%,86.3%;68.1%,76.1%,71.1%;65.5%,91.5%,75.3%。CEUS联合UE调整BI-RADS分类后的敏感度98.3%,特异度88.7%,准确率94.7%。结论 CEUS在乳腺良恶性病灶的鉴别上有一定的应用价值,CEUS联合UE能进一步提高BI-RADS 4类乳腺病灶的良、恶性鉴别诊断。     

应变率比值法与面积比值法联合应用在乳腺结节鉴别诊断中的价值

目的探讨超声弹性成像(ultrasound elastography,UE)技术应变率比值(strain ratio,SR)与面积比值联合应用在乳腺结节(BI-RADS 4类、直径≤2cm)鉴别诊断中的价值,为临床诊断及治疗提供重要依据。方法对60例女性患者检出的69个乳腺结节,常规超声检查后启用超声弹性成像模式,获得结节的应变率比值及面积比值,并根据应变率比值3.08为良性,≥3.08为恶性,面积比值1.1为良性,≥1.1为恶性,判定结节的良恶性,并与病理结果进行对照。结果超声弹性成像应变率比值的准确性为92.8%,超声弹性成像面积比值的准确性为88.4%,超声弹性成像应变率比值联合面积比值诊断的准确性为94.2%。结论超声弹性成像应变率比值与面积比值联合应用可以提高乳腺结节鉴别诊断的准确性。     

实时超声造影对提高乳腺肿瘤BI-RADS分类准确性的价值

目的探讨超声造影对提高乳腺肿瘤乳腺影像报告和数据系统(BI-RADS)分类准确性的价值。资料与方法收集151个乳腺肿瘤的常规超声及超声造影资料,根据常规超声进行BI-RADS分类;并行超声造影检查,结合病灶造影增强扫描特点重新进行分类,与病理结果进行比较,并比较常规超声BI-RADS分类与结合超声造影的BI-RADS分类对乳腺肿物恶性风险分层的评估能力。结果结合超声造影增强扫描特点后,BI-RADS分类的变化主要发生在3类和4A类,常规超声BI-RADS分类评估诊断敏感度、特异度、准确度、阳性预测值、阴性预测值分别为92.2%、52.1%、72.8%、80.5%、75.7%;结合超声造影图像特点后的BI-RADS分类,其诊断特异度、准确度、阴性预测值分别提高至72.9%、86.8%、83.3%,与常规超声比较,差异有统计学意义(P<0.05)。常规超声BI-RADS分类评估ROC曲线下面积为0.802,与结合超声造影后的曲线下面积0.878比较,差异有统计学意义(P<0.05)。结论在常规超声BI-RADS分类的基础上,结合病灶的造影增强模式有助于提高超声BIRADS分类对乳腺肿块恶性风险分层的评估能力。     

超声造影在常规超声BI-RADS 4类乳腺肿块的诊断价值

目的探讨超声造影在常规超声BI-RADS 4类乳腺肿块诊断中的应用价值。方法对收治的64例经乳腺常规超声检查诊断为美国放射学会修订的第5版乳腺影像报告和数据系(breast imaging reporting and data system,BIRADS)4B类的乳腺肿块患者采用超声造影检查,分析其形态学特征和时间-强度曲线定量参数(AT、TTP、PI),进行良恶性的鉴别与诊断。结果良性组和恶性组之间在造影形态、边界、周围穿入或扭曲血管、内部对比剂分布、造影后有无显著增大等方面比较均存在明显差异,且差异具有统计学意义。恶性组和良性组之间的AT、TTP、PI等TIC定量参数比较无明显差异(P0.05)。本文69个常规超声BI-RADS 4B类乳腺肿块中经超声造影诊断为恶性46个,良性23个;诊断敏感性为97.62%,特异性为81.48%,准确性为91.30%,阳性预测率为89.13%,阴性预测率为95.65%。结论超声造影可以对常规超声BI-RADS 4类乳腺肿块进一步良恶性鉴别诊断,提高其术前诊断准确率。     

乳腺影像学报告及数据系统评分联合超声弹性成像对乳腺浸润性癌的诊断价值

目的 探讨乳腺影像学报告及数据系统(BI-RADS)评分联合超声弹性成像乳腺浸润性癌的鉴别价值。方法 回顾性分析我院2021年5月至2022年5月期间收治的乳腺肿块患者108例(108个肿块)BI-RADS评分以及超声弹性成像资料，以病理为金标准，采用χ²检验对比BI-RADS评分、超声弹性成像单独及联合对乳腺浸润性特殊癌鉴别的价值，采用t检验对比良恶性肿块超声弹性评分、BI-RADS评分等参数。结果乳腺恶性肿块共58个，占58/108(53.7%)，其中乳头状癌18例、小管癌9例、髓样癌20例、鳞状细胞癌11例；乳腺良性肿块共50个，占50/108(46.3%)，其中乳腺纤维腺瘤27例、乳腺叶状肿瘤14例和乳腺腺瘤9例。与BI-RADS评分、超声弹性成像单独检查相比，BI-RADS评分联合超声弹性成像对乳腺浸润性癌诊断敏感度、阳性预测值更高(χ²=4.83,P=0.03；χ²=3.28,P=0.05；χ²=4.49,P=0.03；χ²=2.94,P=0.05)；恶性肿块的弹性...     

彩色多普勒血流显像与超声弹性成像联合诊断BI-RADS4类乳腺病变

目的 探讨彩色多普勒血流显像(CDFI)与超声弹性成像(UE)联合诊断乳腺影像报告和数据系统(BI-RADS)4类乳腺病变的价值.资料与方法 132例BIRADS4类乳腺病变,根据病变血流Adler半定量分级及弹性评分对BI-RADS分类进行调整,绘制ROC曲线,比较BI-RADS分类及校正BI-RADS分类.结果 132例病灶中,良性病灶75个,恶性病灶57个.CDFI诊断乳腺癌的敏感度为87.72％,特异度为48.00％,准确度为65.15％;UE诊断乳腺癌的敏感度为87.72％,特异度为61.33％,准确度为72.73％.校正BI-RADS分类诊断4类乳腺病变的ROC曲线下面积为0.845,明显高于BI-RADS分类的0.760 (Z=2.963,P＜0.01).结论 CDFI联合UE可以明显提高对BI-RADS 4类乳腺病变的诊断准确率,有效减少不必要的术前活检.     

Optimization of the system of medical service of students of Cadet Schools of the Ministry of Defense of the Russian Federation

One of the factors of the successful military career guidance Cadet schools students is preserving and promoting their health. Medical support of children and adolescents aged 10-17 years should include the full range of medical and preventive measures defined for this group. The state of providing outpatient care for pupils at the Cadet School in St. Petersburg was studied. These results show that full medical care in accordance with the standards can be based only on children's health clinics. It is important that the organization of medical support pupils cadet schools should be cooperate with civilian health care.     

带状疱疹83例误诊原因分析

带状疱疹是由水痘—带状疱疾病毒引起的皮肤科常见疾病。其主要的病理损害,一是受累神经的严重炎症性浸润,继而导致受侵犯神经节内神经细胞变性、坏死;二是皮肤的水泡。迅速抑制神经节和相应的感觉神经纤维的充血、水肿和坏死,防止粘连形成,达到迅速镇痛、改善皮损,缩短病程及防止后遗症的发生是治疗的关键。因而,尽早明确诊断,     

Estimation of accumulated dose of radiation by method of ESR-spectrometry of dental enamel of mammals

ESR-spectrometry was used to investigate radiation-induced paramagnetic centers in enamel of mammals: carnivores (polar bear and fox), ungulates (reindeer, European bison, moose), and man. Values at half the microwave power saturation of the radiation signal, P_1/2, evaluated at room temperature, was found to range from 16 to 26 mW for animals and man. A new approach to discrimination of the radiation induced signal from the total ESR spectrum of reindeer enamel is proposed. ‘Dose-response’ dependencies of enamel of different species mammals were measured within the dose range from 0.48 up to 10.08 Gy. Estimations of ‘radiosensitivity’ enamel of carnivores and ungulates showed good agreement with radiosensitivity enamel of man by ESR method.     

Analysis of the results of the international comparison of activity measurements of a solution of Fe

The results of an international comparison of activity measurements of a solution of ⁵⁵Fe organized by the BIPM in 2005 are reported and analysed. This exercise, which follows the procedures of the CIPM mutual recognition arrangement to update older comparisons, is a renewal of the comparison organized by the BIPM that took place in 1978. A EUROMET comparison was organized in 1996 specifically to compare activity measurements of a ⁵⁵Fe solution by means of liquid-scintillation techniques. Results of these three comparisons are presented and discussed in this paper.

The radionuclide solution was provided by the NPL, which also distributed the samples to the participants. The activity of the ampoules was measured by 16 laboratories using 12 methods producing 25 results. Some general considerations on uncertainty assessments pertaining to the different techniques used are drawn. The outcome of four different estimators is compared from which the presence of at least one outlier can be confirmed. Further measurements should be made to try to reduce the discrepancy between the results. To date the outcome of the present comparison does not show an improvement to that of the 1996 comparison.     

Evaluation of the results of various technics of non-surgical therapy of varicocele

A new method of non-surgical treatment of varicocele syndrome is described: it consists in sclerotherapy of spermatic vein by trans-femoral percutaneous catheterization with balloon-catheters. In 8 cases venous thrombosis has been induced by direct electric clotting. The techniques and a 6 months follow-up are discussed. It is pointed out that this procedure should be considered as the method of choice for tubular lesions and sub-fertility prophylaxis in young people and in childhood.     

延迟性脾破裂误漏诊原因分析

目的探讨延迟性脾破裂误漏诊原因和预防措施.方法回顾性分析总结12例延迟性脾破裂中的诊断和误漏诊的经验与教训.结果本组延迟性脾破裂的误漏诊5例(41.66%).对多发伤与脾破裂并存可能认识不足,外伤史轻微或伤员隐瞒外伤史,缺乏腹痛-缓解-突然再腹痛的典型病史,缺乏“对冲性脾破裂”力学分析和整体化诊断思路等为其误漏诊的主要原因.结论详细的外伤史和全面系统检查,重视腹以外多发伤掩盖腹内脏器伤及延迟性脾破裂可能.确立外伤-腹内脏器伤-脾破裂整体化诊断思路.不间断地辅以B超检查脾形态学变化和腹内有无积液,腹腔穿刺确定有无血腹、X线胸腹部检查观察左侧胸肋角和膈肌运动情况、必要时CT检查以尽早发现脾包膜下血肿,降低延迟性脾破裂误漏诊率.