弹性成像应变率比值法与弹性评分法诊断宫颈占位性病变的价值比较

目的探讨超声弹性成像在宫颈占位性病变中的诊断价值,并将评分法与应用率比值法相比较。方法对116例疑为宫颈占位性患者(共116个病灶),于术前行弹性成像检查,进行弹性评分与应变率比值测定。构建两种方法的受试者工作特征曲线(Receiver operating characteristic curve,ROC曲线),比较两者的准确性。结果弹性评分法诊断宫颈占位性病变良恶性的敏感度、特异度、准确度、阳性预测值、阴性预测值分别为77.63%、82.50%、79.31%、89.39%和66.00%。良、恶性组应变率比值分别为(2.56±1.94)和(6.88±2.03),两组差异有显著性。计算ROC曲线下面积(area under curve,AUC)评分法、应变率比值法分别为0.901和0.918,当选取应变率比值阈值为4.045时,敏感度、特异度、准确性、阳性预测值及阴性预测值分别为84.21%、87.50%、85.34%、92.75%和74.47%。结论超声弹性成像在宫颈占位性病变诊断中,具有较高诊断价值。应变率比值法准确性高于弹性评分法。     

腮腺占位性病变采用实时超声弹性成像的价值分析

目的 总结对腮腺占位性病变诊断时,采用实时超声弹性成像的价值.方法 选取2016年3月至2017年5月该院腮腺占位性病变71例,腮腺病灶数为83个.以弹性评分作为依据,对全体患者的病灶进行诊断,记录病理结果对比情况.据手术病理结果将全体病灶分良性组和恶性组.结果 根据病理结果和超声弹性评分可以看出,恶性组评分高的病灶数量更多,良性组则评分普遍较低.良性组弹性评分为2.19士0.63,恶性组弹性评分为3.21±0.32.弹性评分法的正确率为78.31％,Youden指数为61.23％;二维超声的正确率为79.52％,Youden指数为60.02％;多普勒超声的正确率为72.29％,Youden指数为32.57％.与多普勒超声法相比,其余两种诊断方式真实性更高,差异有统计学意义(P＜0.05);而二维超声和弹性评分法之间并不存在明显差异(P＞0.05).结论 对腮腺占位性病变诊断时,采用实时超声弹性成像能够对腮腺占位病变的性质进行诊断.     

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。     

评价超声弹性成像对乳腺肿块良恶性的鉴别诊断价值

目的探讨超声弹性成像鉴别诊断乳腺肿块良恶性的临床价值。方法将本院2014年12月~2015年12月收治的乳腺肿块患者62例作为研究对象,行超声弹性成像检查,比较良恶性肿瘤面积比与应变率比值,由此评价该检查方式的鉴别诊断价值。结果62例患者共62个乳腺肿块,其中43.5%为良性,56.5%为恶性;良性应变率比值为(2.18±0.64),恶性为(3.29±0.95);良性面积比为(1.51±0.41),恶性为(1.92±0.64),对比差异明显(P0.05)。结论超声弹性成像可作为有效方式诊断鉴别乳腺肿块良恶性,但还需结合实际与其他方式联合运用,以提升诊断率。     

超声弹性成像在乳腺良恶性病变鉴别诊断的应用

目的探讨超声弹性成像在乳腺良恶性病变鉴别诊断中的应用价值.方法对20例乳腺疾病患者的37个病灶的弹性成像图与手术后病理及随访结果进行分析.结果超声弹性成像评分1-3分多为良性病变,4-5分多为恶性病变.以弹性评分≥4分诊断乳腺恶性病变、弹性评分<4分诊断乳腺良性病变,敏感性100%,特异性93.10%,准确度94.59%.弹性应变率比值(strain ratio,SR)在良恶性病变组间有统计学意义(P<0.05).结论超声弹性成像在乳腺良恶性病变鉴别诊断中结合二维及彩色多普勒显像可提高恶性病变诊断的敏感性、特异性和正确性,具有较高的应用价值.     

超声内镜实时组织弹性成像鉴别诊断消化系统肿瘤良恶性临床分析

目的探讨超声内镜实时组织弹性成像鉴别诊断消化系统肿瘤良恶性的效果。方法选取2014年1月至2015年1月信阳市中医院收治的消化系统肿瘤患者53例,共79个消化系统实质性肿瘤病灶,所有患者均采用超声内镜实时组织弹性成像诊断,使用弹性成像评分,对患者病灶及其周围对照组织的弹性应变率比值进行测量并对比分析。结果良性病灶组超声弹性成像评分与恶性病灶组相比,差异有统计学意义(P<0.05);良性病灶组弹性应变率比值低于恶性病灶组(P<0.05);超声内镜实时组织弹性成像诊断准确率为91.14%、敏感性为94.74%、特异性为81.82%。结论超声内镜实时组织弹性成像鉴别诊断消化系统肿瘤效果显著,可有效判定肿瘤良恶性,提高诊断准确性。     

经阴道实时超声弹性成像在宫颈癌前病变与宫颈癌鉴别诊断中的价值

目的:探讨经阴道实时超声弹性成像在宫颈癌前病变与宫颈癌鉴别诊断中的价值。方法:选取2016年5月-2017年5月本院收治的宫颈癌患者50例、宫颈癌前病变患者50例分别设为研究组和试验组,另选宫颈正常查体者50例为对照组。三组均经阴道实时超声弹性成像检查,分析检查结果。结果:研究组超声弹性成像评分均高于试验组、对照组(P0.05);研究组超声弹性成像评分为3、4、5分比例明显高于试验组、对照组,比较差异均有统计学意义(P0.05);将超声弹性成像评分≥3分作为截断值时,诊断正确率、敏感性及特异性分别为92.0%、94.0%、91.0%;超声弹性成像诊断宫颈癌病灶长径、横径、前后径长度与病理结果比较差异均无统计学意义(P0.05);研究组弹性应变率比值为(2.73±1.28),明显高于试验组的(0.81±0.14),比较差异有统计学意义(P0.05)。结论:经阴道实时超声弹性成像能够有效鉴别诊断宫颈癌前病变与宫颈癌,且可较为准确判断宫颈癌病灶大小,具有较高临床应用价值。     

超声弹性成像在乳腺微小结节鉴别诊断中的应用

目的:探讨超声弹性成像在乳腺微小结节良恶性鉴别诊断中的应用价值。方法:对102例患者的128个乳腺微小实性结节(直径≤10 mm)进行二维彩色多普勒超声扫查,同时进行弹性成像。测量肿块组织与周围组织弹性应变率比值,对照术后病理结果进行回顾性分析乳腺良、恶性微小结节的超声弹性成像特点。结果:128个结节中,良性99个,恶性29个,良、恶性乳腺结节弹性应变率比值分别为(2.16±1.29)和(6.85±4.07),两者差异有统计学意义(P0.05)。二维彩色多普勒超声结合弹性应变率比值诊断恶性结节的准确率为92.33%。结论:以二维彩色多普勒超声为基础,结合弹性成像技术,在乳腺良、恶性微小结节的鉴别诊断中具有较高的临床应用价值。     

超声弹性成像比值法在鉴别甲状腺结节中的价值

目的 探讨超声弹性成像(UE)比值法在鉴别甲状腺结节良恶性中的诊断价值.方法 应用UE比值法对48例共62个甲状腺结节进行检查,测量结节与周围正常甲状腺组织弹性应变率的比值,以3.30为界点判断结节的良恶性.结果 病理诊断62个结节中,良性42个,恶性20个;良性肿块弹性应变率比值为1.93±1.39,明显低于恶性结节的弹性应变率比值的6.38±4.67(P＜0.05).UE比值法诊断恶性结节的敏感性为85.0%,特异性为90.5%,准确性为88.7%.结论 UE比值法对鉴别甲状腺结节的良恶性有较高的诊断价值.     

彩超联合超声弹性成像在甲状腺占位性病变诊断中的应用

目的 探讨甲状腺占位性病变诊断中彩色多普勒超声联合超声弹性成像的应用价值.方法 选取我院甲状腺手术患者54例,共91个病灶,对其术前超声检查结果与术后病理诊断结果进行对比.结果 彩色多普勒超声诊断结果,32个病灶为恶性占位性病变,59个病灶为良性占位性病变,13个误诊;彩色多普勒超声联合超声弹性成像诊断结果,26个病灶为恶性占位性病变,65个病灶为良性占位性病变,4个误诊;评分结果,恶性病灶中,2个7分,4个6分,20个5分,2个4分,2个3分;良性病灶中,1个5分,7个4分,13个3分,27个2分,13个1分.结论 彩色多普勒超声联合超声弹性成像可有效减少甲状腺占位性病变误诊率,且评分结果表现为差异性,值得推广.     

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.