钼靶x线摄影联合超声弹性成像在诊断乳腺肿块性质中的价值研究

目的：探讨钼靶x线摄影联合超声弹性成像在判断乳腺肿块性质中的价值研究。方法：选择92例患者,共100个乳腺肿块,分别进行钼靶x线摄影、超声弹性成像,分别判断肿块的良恶性,按分析方法分为3组：钼靶x线摄影组、超声弹性成像组,钼靶x线摄影和超声弹性成像联合应用组,最后做统计学分析。结果：100个乳腺肿块中病理证实恶性肿块54例,良性46例,钼靶x线检摄影检查恶性病变的敏感性、特异性和准确性分别为87％,91．3％,89％;超声弹性成像诊断恶性病变的敏感性、特异性和准确性分别为92．5％,89．1％,91％;钼靶x线摄影和超声弹性成像联合应用诊断恶性病变的敏感性、特异性和准确性分别为96％．95．6％．96％。结论：钼靶联合超声弹性成像在判断乳腺肿块性质方面的价值大于两者单独应用的价值。     

超声弹性成像联合常规超声在乳腺肿块中的应用

目的探讨实时组织超声弹性成像（RTE）及常规超声在乳腺肿块中的诊断价值。方法对2008年12月～2010年6月126例（共148个病灶）来我院检查的乳腺肿块患者行常规超声及超声弹性检查,对照术后病理结果,回顾性分析常规超声及超声弹性成像乳腺肿块的特征。结果148处病灶中良性病灶106例,恶性病灶为42例;组织弹性成像技术对乳腺肿块良恶性的诊断的准确性为91．9％（136／148）,特异性为96．0％（97／101）,敏感性为83．0％（39／47）。结论超声弹性成像联合应用常规超声可提高乳腺肿块诊断的准确性,特别对于一些小病灶的良恶性鉴别诊断上具有较高的临床应用价值。     

常规超声、超声弹性成像及二者联合鉴别诊断乳腺肿块良恶性的效果分析

目的：探讨常规超声、超声弹性成像（UE）及二者联合在鉴别乳腺肿块良恶性中的应用价值。方法对125个乳腺肿块的常规超声特点、弹性成像图进行分析,并且和病理金标准对照,通过受试者工作特征（ROC）曲线下面积的比较,对二者单独及联合应用鉴别乳腺肿块的效果分别进行评估。结果常规超声、超声弹性成像及二者联合诊断乳腺肿块良恶性的结果与病理检查的符合率为77．6％、84．8％和92．0％;3种检查方法诊断乳腺恶性肿块的符合率分别为61．9％、76．2％、90．4％。二者联合鉴别乳腺肿块良恶性的 ROC曲线下面积（0．947）大于单独常规超声（0．843）（Z ＝2．57,P ＝0．01）、超声弹性成像（0．899）（Z＝1．52,P ＝0．12）。结论常规超声与弹性成像联合应用可有效提高乳腺癌的诊断符合率。     

实时超声弹性成像在鉴别乳腺肿块中的诊断价值

目的探讨实时超声弹性成像技术在鉴别乳腺肿块中的诊断价值。方法应用实时超声弹性成像技术对58例患者共66个肿块行术前超声检查,测量肿块组织与周围组织弹性应变率的比值．以3．08为界点判断肿块的良恶性,所有病灶均经手术病理证实。结果66个肿块中,良性45个,恶性21个,良性肿块弹性应变率比值为（1．88±1．29）,恶性肿块的弹性应变率比值为（5．79±5．36）,两者的差异有统计学意义（P〈0．01）。以3．08为界点判断肿块的良恶性、诊断恶性肿块的敏感性95．2％,特异性88．9％,准确性90．9％。结论实时超声弹性成像技术对鉴别乳腺肿块的良恶性有较高的诊断价值。     

探讨超声弹性成像在乳腺肿块诊断中的应用价值

目的探讨超声弹性成像在诊断乳腺肿块及良、恶性肿块鉴别诊断中的临床价值。方法对广西贺州市中医医院2010~2013年收治的78例乳腺肿块患者（共79个乳腺肿块）在手术治疗前行常规超声检查及超声弹性成像检查,并与术后病理检查结果进行对比分析。结果超声弹性成像的良性肿块诊断符合率为94.44%、恶性肿块诊断符合率为92.0%;常规超声检查的良性肿块诊断符合率为79.63%、恶性肿块诊断符合率为64.0%;超声弹性成像对乳腺良、恶性肿块的诊断符合率均明显高于常规超声检查,差异有统计学意义（P〈0.05）。结论超声弹性成像用于临床诊断乳腺肿块及良、恶性肿块的鉴别诊断效果显著,值得临床推广应用。     

超声弹性成像与常规超声联合应用在诊断乳腺肿块中的价值

目的:研究常规超声与实时超声弹性成像在鉴别诊断乳腺肿块良、恶性中的价值,并探讨影响诊断的因素。方法:收集我院经手术病理证实良、恶性的154例、158个乳腺肿块,术前均行常规超声及实时超声弹性成像检查,检查结果与术后病理进行对照比较。结果:术后病理证实158个乳腺肿块中,良性115个,恶性43个。常规超声、弹性成像、常规超声与弹性成像联合应用诊断结节良、恶性与术后病理诊断结果的一致性,kappa值分别为0.6059、0.7283、0.8137。结论:常规超声检查是乳腺超声检查的基础,超声弹性成像技术有利于鉴别乳腺肿块的良、恶性,二者联合应用能够很好地提高诊断准确率。     

超声弹性成像技术应变率比值法鉴别诊断乳腺肿块良恶性的价值分析

目的：探讨分析超声弹性成像技术应变率比值法鉴别诊断乳腺肿块良恶性的价值。方法：选取该院2012年3月至2014年3月收治检出乳腺肿块的患者180例,所有患者均应用超声弹性成像技术应变率比值法,测算得出乳腺肿块与周围同水平正常乳腺组织的应变率比值（SR）,并将结果与手术病理结果比较,以病理结果为金标准,分析 SR 值鉴别乳腺肿块良恶性的最佳诊断界点。结果：恶性肿瘤 SR 值（5．21±2．64）显著大于良性肿瘤（1．43±1．02）,差异有统计学意义（P ＜0．05）。鉴别乳腺肿块良恶性的最佳诊断界点为2．91,SR 值鉴别乳腺肿块良恶性的敏感性、特异性及准确性分别为87．2％、83．1％、84．1％。结论：超声弹性成像技术应变率比值法鉴别诊断乳腺肿块良恶性具有较高临床价值,值得推广应用。     

彩超与超声弹性成像对乳腺肿块的诊断对比

目的:分析乳腺肿块经彩超与超声弹性成像检查的临床诊断价值.方法:选择2018年3月-2020年3月期间经濮阳市人民医院超声科检查并经手术病理证实的120例乳腺肿块患者,共计158个病灶,所有患者均经彩色多普勒超声和超声弹性成像检查,并经手术病理证实,将手术病理结果作为诊断的"金标准",比较彩超、超声弹性成像及联合诊断对乳腺肿块的诊断价值.结果:联合诊断恶性检出率高于彩超、超声弹性成像单独检测,差异有统计学意义(P<0.001).联合诊断乳腺病灶良恶性的灵敏度87.65％、特异度97.40％、准确度92.41％高于彩超的64.20％、77.92％、70.89％和超声弹性成像的69.14％、81.82％、75.32％单独检测,差异有统计学意义(P<0.05).结论:彩超与超声弹性成像联合诊断能准确区分乳腺良恶性肿块,具有较高的灵敏度、特异度、准确度,可为乳腺肿块的临床诊断和治疗提供重要依据.     

实时超声弹性成像技术在乳腺良恶性肿块鉴别中的应用价值

目的分析实时超声弹性成像技术在乳腺良恶性肿块鉴别中的应用价值。方法以术后病理诊断为金标准,对81例(119个)乳腺结节患者行超声检查,分析弹性成像对于诊断乳腺肿块良、恶性的准确性。结果经病理检查得出:良性结节共有90个,所占比例为75.6%;恶性结节共有29个,所占比例为24.4%。采用超声弹性成像5分评分法,其结果为敏感度82.76%,特异度88.89%,准确度88.24%。结论在诊断和鉴别诊断乳腺良、恶性肿块时应用超声弹性成像技术可以得到较高准确性的结果 ,临床应用价值值得肯定。     

高频超声钙化特征与弹性成像对乳腺肿瘤的诊断价值

目的：探讨超声弹性成像与钙化特征在乳腺肿块良恶性鉴别诊断中的价值。方法：对90例（105个病灶）乳腺肿块女性患者的超声钙化及弹性成像特点和术后病理结果对照,对两者鉴别乳腺肿块的灵敏性、特异性和准确性进行评估。结果：以钙化特点为标准诊断乳腺肿块性质的灵敏度、特异度、准确度分别为69.4％、85.5％、80.0％;弹性成像依次分别为77.8％、94.2％、88.6％,以上指标均高于钙化特征,差异有统计学意义（P＜0.05）。结论：与钙化特点相比,弹性成像在诊断乳腺肿瘤良恶性中具有更高的敏感性及特异性,可作为诊断乳腺肿瘤良恶性的重要手段。     

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.     

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.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.