ROC曲线评估超声造影对三阴性乳腺癌腋窝淋巴结的诊断价值

目的:分析对比增强超声造影对三阴性乳腺癌TAC化疗前腋窝淋巴结状态的评估价值,并采用ROC曲线评估其诊断腋窝淋巴结转移的价值。方法:选择2016年3月-2018年5月在本院诊治的86例三阴性乳腺癌患者作为研究对象,所有患者在进行化疗前均进行对比增强超声造影检查,以术后病理诊断结果为金标准,分析对比增强超声造影评估腋窝淋巴结转移的敏感性和特异性,比较腋窝淋巴结转移和未转移患者的对比增强超声造影检查参数,以淋巴结实质内高灌注区和低灌注区的差异度（SImax-SImin）做ROC曲线,分析对比增强超声造影对患者腋窝淋巴结转移的诊断价值。结果:病理检查结果腋窝淋巴结转移41例;对比增强超声造影检查结果34例腋窝淋巴结转移,52例未见淋巴结转移,其中假阳性2例,假阴性9例,其评估乳腺癌腋窝淋巴结转移的敏感性为78.05％,特异性为95.56％,阳性预测值为94.12％,阴性预测值为82.69％;腋窝淋巴结转移组SImax-SImin显著大于淋巴结未转移组,当SImax-SImin大于临界值20.96时,对比增强超声造影鉴别乳腺癌腋窝淋巴结转移的敏感性为85.29％,特异性为80.77％。结论:对比增强超声造影在三阴性乳腺癌TAC化疗前腋窝淋巴结状态评估和淋巴结转移诊断中具有较高的敏感性和特异性,可用于临床指导三阴性乳腺癌治疗方式及腋窝手术方式。     

超声造影引导下细针穿刺活检在乳腺癌前哨淋巴结转移中的诊断价值

目的 探讨超声造影引导下细针穿刺活检在乳腺癌前哨淋巴结转移中的诊断价值.方法 选取110例乳腺癌患者,均行超声造影引导下细针穿刺活检,以前哨淋巴结活检术结果为金标准,评估超声造影引导下细针穿刺活检对乳腺癌前哨淋巴结转移的诊断价值.结果 前哨淋巴结活检结果显示,110例乳腺癌患者中,存在前哨淋巴结转移60例,无转移50例.超声造影引导下细针穿刺活检诊断乳腺癌前哨淋巴结转移的曲线下面积(AUC)为0.876(95％CI:0.721～0.912),灵敏度为83.33％、特异度为60.00％、阳性预测值为71.43％、阴性预测值为75.00％、准确度为72.73％.结论 超声造影引导下细针穿刺活检在乳腺癌前哨淋巴结转移中有较高的诊断价值.     

超声造影诊断乳腺肿瘤的临床应用进展

乳腺癌是女性常见的恶性肿瘤,发病率占女性恶性肿瘤首位,死亡率为第２位。常规超声和钼靶Ｘ线是乳腺肿瘤最常见的影像检查手段,但由于各自方法的局限性,其临床效果不甚理想。目前超声造影技术迅速发展,使乳腺良恶性肿瘤的诊断与鉴别诊断的准确性明显提高。本文就近年来超声造影对乳腺癌诊断的临床研究作一综述。     

高频超声联合超声造影在年轻乳腺癌诊断中的应用研究

目的 探讨高频超声联合超声造影在年轻乳腺癌诊断中的应用价值.方法 选择103例女性乳腺癌患者(共103个病灶)为研究对象,依据患者年龄分为两组,对照组62例(年龄﹥35岁),研究组41例(年龄≤35岁).所有患者均接受高频超声联合超声造影检查,比较分析两组患者的超声图像特征.结果 研究组病灶的回声晕发生率和后方回声衰减率低于对照组,内部回声不均匀发生率高于对照组,差异均有统计学意义(P﹤0.05);研究组病灶造影前及造影后的横径均大于对照组,造影前纵横比、造影后横径差值均小于对照组,差异有统计学意义(P﹤0.01);研究组造影剂滞留率低于对照组,病灶快进快退率高于对照组,差异均有统计学意义(P﹤0.01).结论 高频超声联合超声造影在年轻乳腺癌诊断中具有重要价值,值得临床推广.     

乳腺常规超声与超声造影对早期乳腺癌的诊断价值

目的探讨乳腺常规超声与超声造影对早期乳腺癌的诊断价值。方法选取2016年5月至2019年5月间西安交通大学第二附属医院收治的80例早期乳腺癌患者进行回顾性研究,所有患者分别进行常规超声检查和超声造影检查。分析良恶性乳腺肿瘤的特征,并与穿刺或术后病理结果进行比较,分析两种检测方法的诊断价值。结果超声造影结果提示,乳腺恶性肿瘤主要为不均匀增强及周边增强,乳腺良性肿瘤主要为无增强和均匀增强为主。33例患者经常规超声诊断,良性16例,恶性17例,其中误诊10例(4例误诊为良性,6例误诊为恶性); 47例患者经超声造影诊断,良性12例,恶性35例,其中误诊5例(良性误诊2例、恶性误诊3例)。常规超声诊断良恶性乳腺疾病的敏感性、特异性、阳性预测值和阴性预测值分别为64. 7%、75. 0%、73. 3%和66. 7%。超声造影诊断良恶性乳腺疾病的敏感性、特异性、阳性预测值和阴性预测值分别为94. 1%、76. 9%、91. 4%和83. 3%。超声造影的敏感度明显高于常规造影,差异有统计学意义(P <0. 05)。结论常规超声联合超声造影可提高早期乳腺癌的诊断敏感度,在早期乳腺癌的诊断以及良恶性肿瘤的鉴别诊断中有重要的临床应用价值。     

多模态超声技术在乳腺癌新辅助化疗疗效评估中的应用

随着诊疗技术的发展，乳腺癌进入多种模式相结合的综合治疗时代，新辅助化疗因具有使乳腺癌降期、提高保乳率等优势，应用日渐广泛。早期准确评估疗效对乳腺癌个体化治疗和预后至关重要。目前常见的超声诊断方式包括常规超声、彩色多普勒超声、超声造影、超声弹性成像、自动乳腺全容积成像等技术，因安全无创、操作简单及重复性强等众多优势，被广泛用于乳腺癌治疗前后的疗效评估。本文主要针对多模态超声成像技术在乳腺癌新辅助化疗疗效评估中的应用进行综述。     

高频彩色多普勒超声联合超声造影在乳腺癌腋下转移性淋巴结鉴别诊断中的应用

目的:探讨高频彩色多普勒超声联合超声造影对乳腺癌腋下转移性淋巴结鉴别诊断的价值.方法:收集2017年1月至2018年6月入住我院并经病理证实的女性乳腺癌患者87例,转移淋巴结患者45例,未转移患者42例,所有患者术前均行高频彩色多普超声检查和超声造影检查,对高频彩色多普超声检查和超声造影检查的诊断结果进行分析.结果:乳...     

超声造影评估乳腺癌周围血管受侵程度及可切除性的价值

目的探讨超声造影评估乳腺癌周围血管受侵程度及可切除性的价值。方法选择诊治的乳腺癌患者98例作为研究对象,所有患者都给予超声造影检查,记录造影特征并判定周围血管受侵程度及可切除性。结果在98例患者中,超声造影达峰时间为(16.44±0.65)s,峰值强度为(0.16±0.05)dB。诊断为周围血管受侵85例,其中动脉血管受侵48例,静脉血管受侵37例,判断周围血管受侵程度的准确率为88.8%,Kappa值为0.789。超声造影判断乳腺癌可切除性的敏感性、特异性、准确性为96.2%、95.0%和95.9%。COX风险回归模型结果显示临床分期、年龄、周围血管受侵、达峰时间、峰值强度都为影响手术切除的主要独立危险因素(P<0.05)。结论超声造影可准确评估乳腺癌周围血管受侵程度及可切除性,有助于病情判断与手术治疗,具有很好的应用价值。     

超声造影联合HER-2、TPS对乳腺癌新辅助化疗敏感性的预测价值

目的 研究超声造影联合HER-2、TPS对乳腺癌新辅助化疗敏感性的预测价值。方法 选取74例接受新辅助化疗的乳腺癌患者作为研究对象,根据新辅助化疗治疗效果分为敏感组(n=49)和不敏感组(n=25)。2组患者均接受超声造影检查,同时对比2组患者HER-2、组织多肽特异性抗原(TPS)水平,绘制ROC曲线分析超声造影联合HER-2、TPS对乳腺癌新辅助化疗敏感性的预测价值。结果 与敏感组相比,不敏感组患者病灶始增时间和峰值时间显著更长(P<0.05);与敏感组相比,不敏感组患者血清HER-2和TPS水平显著更高(P<0.05)。应用受试者工作特征曲线评估乳腺癌新辅助化疗敏感性得出：超声造影预测乳腺癌新辅助化疗敏感性灵敏度89.8%和特异度为64.0%;HER-2预测乳腺癌新辅助化疗敏感性灵敏度为91.8%和特异度为80.0%;TPS预测乳腺癌新辅助化疗敏感性灵敏度91.9%和特异度为80.0%,三者联合预测乳腺癌新辅助化疗敏感性灵敏度为93.8%,特异度为92.0%,经分析得出,三者联合的预测灵敏度和特异度均高于各项单独检测(P<0.05)。结论 超声造影联合HER-2...     

超声造影及弹性成像技术在乳腺癌新辅助化疗疗效评估中的应用价值

目的 探讨超声造影及弹性成像技术在乳腺癌新辅助化疗疗效评估中的应用价值.方法 将100例乳腺癌患者完成化疗周期后进行超声造影及超声弹性成像检查,比较两种检查方式的灵敏度、特异度、准确度,绘制受试者工作特征(ROC)曲线并计算其曲线下面积(AUC),分析两种检查方式在乳腺癌新辅助化疗疗效中的评估价值.结果 病理学检查结果显示,14例化疗后病灶消失,65例化疗后病灶缩小,21例化疗后病灶无明显变化或增大.超声造影检查评估乳腺癌新辅助化疗疗效的灵敏度、特异度、准确度分别为92.41％、85.71％、91.00％,超声弹性成像检查评估乳腺癌新辅助化疗疗效分别为87.34％、71.43％、84.00％,两种检查方式比较差异均无统计学意义(P﹥0.05).超声造影及弹性成像检查评估乳腺癌新辅助化疗疗效结果与病理学检查结果的一致性均较好(Kappa=0.689,P=0.014;Kappa=0.648,P=0.029).ROC曲线分析结果显示,两种检查方式的AUC比较,差异无统计学意义(P﹥0.05).结论 超声弹性成像及超声造影在评估乳腺癌新辅助化疗疗效方面与病理学检查结果具有较高的一致性,两种检查方式诊断效能相当,临床实际应用过程中可结合患者的实际情况选择适合的检查方式.     

Ringworm in animals in a farm in Assiut

Bericht über das Auftreten von Hautmykosen bei Tieren auf der Farm der Landwirtschaftlichen Fakultät der Universität Assiut. Von 70 Kälbern waren 42 pilzkrank, davon 22 durch T. mentagrophytes, 20 durch T. verrucosum. Von 180 Kühen waren 8 pilzbefalien, sämtlich durch T. mentagrophytes. Von 2 kranken Bullen wurde T. verrucosum isoliert. Auch die 3 Pferde und 2 Maultiere der Farm waren pilzinfiziert; Erreger war in diesen Fällen T. equinum. Auch ein Kalb war von T. equinum befallen. Die gleiche Pilzart wurde ferner von 3 Tierpflegern isoliert, die Pilzherde am Hals und an den Armen aufwiesen.     

Statistical challenges in preprocessing in microarray experiments in cancer

Many clinical studies incorporate genomic experiments to investigate the potential associations between high-dimensional molecular data and clinical outcome. A critical first step in the statistical analyses of these experiments is that the molecular data are preprocessed. This article provides an overview of preprocessing methods, including summary algorithms and quality control metrics for microarrays. Some of the ramifications and effects that preprocessing methods have on the statistical results are illustrated. The discussions are centered around a microarray experiment based on lung cancer tumor samples with survival as the clinical outcome of interest. The procedures that are presented focus on the array platform used in this study. However, many of these issues are more general and are applicable to other instruments for genome-wide investigation. The discussions here will provide insight into the statistical challenges in preprocessing microarrays used in clinical studies of cancer. These challenges should not be viewed as inconsequential nuisances but rather as important issues that need to be addressed so that informed conclusions can be drawn.     

Trends in zygomycosis in children

Zygomycosis, or mucormycosis, is associated with significant morbidity and mortality in both children and adults. Studies in adults have shown an increase in the incidence of zygomycosis, particularly among haemtopoietic stem cell transplant (HSCT) recipients and patients with haematologic malignancies. There is a paucity of data on the epidemiology of zygomycosis in children. We performed a retrospective analysis to describe trends in zygomycosis between 1 January 2003 and 31 December 2010. We used the Pediatric Health Information System (PHIS) database to identify paediatric patients who were diagnosed with zygomycosis during the study period. Administrative data on diagnoses, demographics, underlying conditions and clinical experiences were collected. Summary statistics were calculated and tests for trend were conducted. We identified 156 unique patients with zygomycosis. The prevalence of zygomycosis did not significantly increase over time (P=0.284). The most common underlying condition was malignancy (58%) and over half received intensive care. Voriconazole utilisation among all hospitalised children significantly increased during the period (P=0.010). Our study demonstrates that the incidence of zygomycosis is not significantly increasing. During the time period there was a significant increase in the use of voriconazole among children.     

Hemoglobin in lymphogranulomatosis in children

The peculiarities of hemoglobin content and properties in lymphogranulomatosis were studied in children by different methods. In most patients the content of fetal hemoglobin and methhemoglobin was found to increase and the rate of ferricyanide oxidation of hemoglobin also increases. Simultaneously, the rate of non-homogenicity of basic hemoglobin fractions was observed to increase on account of immunologically different components.     

Dermatomycosis in Goats in India

Summary: In an extensive survey involving 2176 goats 1.56% of goats manifested clinical lesions of ringworm infection. Animals below the age of 6 months were affected most (4.20%). The incidence of infection was higher during the winter months. T. verrucosum, T. mentagrophytes and M. gypseum were isolated from the skin scrapings of 12, 4, and 2 goats respectively. It is suggested that the infected animals could be a source of disease to human population in which the zoophilic dermatophyte invasion is characterized by severe inflammatory lesions of the skin. The zoonotic importance of different dermatophytes is stressed.
Zusammenfassung: In einer ausgedehnten Untersuchung an 2176 Ziegen wurden bei 1,56% klinische Zeichen einer Hautmykose festgestellt. Tiere, die jühger als 6 Monate alt waren, zeigten mit 4,20% am häfigsten Krankheitssymptome. In den Wintermonaten war die Erkrankungshäufigkeit am gröBten. T. vermcosum, T. mentagrophytes and M. gypseum wurden jeweils von 12,4 bzw. 2 Ziegen isoliert. Die inflzierten Tiere köinnen eine Infektionsquelle für die menschliche Bevölkerung darstellen und dort Mykosen mit stark entzündlichen Veränderungen auslösen. Die Bedeutung verschiedener Dermatophyten als Erreger von Zoonosen wird hervorgehoben.     

Sex hormones in women in rural China and in Britain

Plasma concentrations of certain hormones linked to breast cancer risk were measured in age-pooled samples from 3,250 rural Chinese women in 65 counties, and 300 British women, all aged 35-64. In age-groups 35-44, 45-54 and 55-64 respectively, mean oestradiol concentrations were 36% (P = 0.043), 90% (P less than 0.001) and 171% (P = 0.001) higher in the British than in the Chinese women, and mean testosterone concentrations were 48% (P less than 0.001), 68% (P less than 0.001) and 53% (P = 0.001) higher in the British than in the Chinese women. The difference in testosterone concentrations between the two countries appeared to be due largely to the lower average body weight in the Chinese women. Sex hormone binding globulin did not differ significantly between the two countries in age groups 35-44 and 45-54, but was 15% (P = 0.002) lower in the British than in the Chinese women at ages 55-64. Prolactin concentrations did not differ significantly between the two countries in any age group.