多层螺旋CT在乳腺疾病检查中的诊断价值分析

<正>乳腺疾病是妇科常见疾病之一。乳腺疾病患者早期阶段多有肿块表现,严重者可发展成为乳腺癌,所以尽早诊断并治疗是保证女性生命健康的前提。近年来,随着医学影像技术的进步,多层螺旋CT技术开始广泛用于乳腺疾病的检查诊断中,并取得了满意的效果,现报告如下。1资料与方法1.1临床资料选择2018年8月—2019年8月于我院治疗的100例乳腺疾病患者为研究对象,均意识清楚,具有配合能力,     

乳腺paget病的临床诊治分析

目的:探究乳腺paget病的临床特点及其诊治方法。方法:从2012年9月至2016年1月间本院收治入院的paget病患者17例进行观察分析,回顾性分析本组患者的临床病例资料,总结paget病患者的临床特点及其诊断和治疗方法。结果:17例患者中手术前有14例患者进行细胞学检查,其中有5例患者呈阳性结果,细胞学诊断阳性率为35.71%,所有患者行乳腺病理组织活检,均诊断为乳腺paget病,其中有3例患者为单纯乳腺paget病,12例患者合并浸润性导管癌,2例患者为浸润性小叶癌。经过手术治疗后,仅有1例患者出现远处转移。结论:早期诊断是提高乳腺paget病患者临床治愈的关键,在诊断中需要特别注意是否合并乳腺肿块,并排除其他乳腺疾病,早期手术治疗。     

乳腺疾病的CR钼靶检查与诊断

目的　探讨乳腺疾病的检查方法,提高早期检出率,以利于早期诊断和治疗。方法　2 4例临床诊断为乳腺肿块的患者行CR钼靶X线摄片(轴位+小角度斜位)。结果　12例(5 0 % )乳腺癌患者X线征象为:毛刺样肿块、簇样钙化;5例(2 1% )腺瘤表现为透晕圈征之肿块;6例(2 5 % )乳腺小叶增生表现为片状模糊影;1例(4% )为炎性肿块。结论　CR钼靶乳腺摄片是当前早期发现及诊断乳腺疾病的最有效方法之一。     

189例乳腺肿瘤的病理诊断与鉴别分析

目的探讨乳腺肿瘤患者的临床病理诊断及鉴别分析.方法回顾性分析我院收治的189例乳腺肿瘤患者(均行术中快速冰冻切片及常规石蜡切片诊断)的临床资料,并对患者的病理诊断与鉴别进行分析.结果189例乳腺肿瘤术中快速冰冻切片诊断中,确诊病例185例,占97.88%;延时诊断4例,占2.12%;无1例误诊病例.结论通过术中快速冰冻切片对乳腺中患者进行诊断及鉴别,诊断准确率高,对患者的治疗及康复有重要的促进作用,值得临床广泛推广应用.     

78例女性乳腺疾病导致乳头溢液的临床诊治体会

目的 探讨乳腺疾病与乳头溢液之间的关系及诊治方法。方法 将78例因女性乳腺疾病而引起乳头溢液的患者，依病程、体征及辅助检查作出相应的诊断、治疗。结果 乳腺疾病与乳头溢液关系密切，对已确诊的乳腺疾病，按良、恶性程度，分别施以保守治疗或不同方式的手术治疗，取得了良好的疗效。结论 乳头溢液是女性乳腺疾病重要的症状与体征，通过对这一现象的早期发现，对乳腺疾病作出早期诊断、早期治疗，具有较大的临床价值。     

高频超声在乳腺肿块诊断中的应用价值探讨

乳腺肿块疾病尤其是乳腺癌,是严重影响妇女身心健康,甚至危及生命的疾病,而早期发现、早期诊断、早期治疗不仅患者个体具有重要的临床意义,而且也具有广泛的社会意义。本文报告应用高频超声检查乳腺肿块的方法,旨在探讨高频超声检查乳腺肿块的应用价值。1临床资料93例受检者为2003-2005年我院门诊收治和住院的乳腺疾病患者及正常体检筛查出的乳腺疾病疑似患者,女92例、男1例;年龄23~69岁,平均43岁。采用日本东芝公司生产的Nemio17彩色多普勒超声诊断仪及7.5MHz的高频探头。患者取仰卧位,充分暴露双侧乳房,以乳头为中心分4个象限放射状多切…     

钼靶X线对乳腺疾病的诊断价值

<正>乳腺疾病是危害妇女健康的主要原因之一,尤其是乳腺癌发病率上升的今天,对乳腺癌的早期发现、早期诊断和早期治疗是改善预后的重要因素。笔者对本院所做乳腺钼靶片进行对比分析,现报告如下。1资料与方法1.1临床资料:2012年7月至2014年3月来我院做乳腺钼靶X线片检查的女性916例,其中,诊断乳腺癌165例,患者年龄28⁷5岁,平均(45±13)岁。1.2方法:采用国产MCR-6000数字化钼靶乳腺X线机,常     

1357例妇女乳腺超声检查结果分析

目的:探讨超声检查在妇女乳腺疾病普查中的应用价值。方法:回顾性分析1357例行二维超声及彩色多普勒检查的患者资料。结果:乳腺小叶增生症885例(65.21%),乳腺纤维腺瘤170例(12.52%),乳管扩张症26例(1.91%),乳腺囊肿30例(2.21%),乳腺脂肪瘤12例(0.88%),乳腺癌7例(0.51%),乳腺导管内乳头状瘤1例(0.07%),双乳未见明显异常226例(16.65%)。结论:运用超声检查对妇女进行乳腺疾病普查对乳腺疾病的早期发现、早期诊断、早期治疗具有极其重要的意义。     

彩色多普勒超声在乳腺检查中的诊断应用价值研究

目的分析彩色多普勒超声在乳腺超声检查的临床结果。方法对该院80例乳腺疾病患者的乳腺超声资料进行回顾性总结。结果 80例患者通过乳腺超声检查发现,乳腺脂肪瘤8例,乳腺小叶增生症为18例,乳腺导管扩张症22例,乳腺癌7例,乳腺纤维瘤14例,乳腺囊肿11例。结论乳腺超声检查对乳腺疾病包括乳腺脂肪瘤、乳腺纤维瘤以及乳腺癌等相关疾病的早期诊断、治疗均具有重要的价值,在临床上的意义重大,值得推广和使用。     

乳腺钼靶X线摄影在乳腺疾病患者诊断中的作用分析

目的:探讨乳腺钼靶X线摄影在临床触诊阴性乳腺疾病患者诊断中的效果。方法:回顾分析69例临床触诊阴性的乳腺疾病患者的临床资料,总结乳腺钼靶X线摄影和乳腺微小钙化灶在临床触诊阴性乳腺疾病患者诊断中的作用。结果:69例触诊阴性乳腺疾病患者中,良性钙化患者中有肿块影11例,无肿块影37例,以无肿块影居多;恶性钙化患者中有肿块影16例,无肿块影5例,以有肿块影居多;良性肿瘤患者微小钙化灶定位活检结果以乳腺增生最为常见,恶性肿瘤患者微小钙化灶定位活检结果以浸润性导管癌最为常见;良性乳腺疾病患者簇状钙化数、钙化点数目以及簇状钙化中钙化颗粒数均较少,钙化灶直径小,簇状钙化密度较低,钙化颗粒大小均匀;恶性乳腺疾病患者则刚好相反,差异有统计学意义(P<0.05)。结论:钼靶X线摄影对钙化灶敏感性高,对乳腺疾病患者的诊断准确率大,再加上费用低,操作简单,可提高乳腺癌患者的早期诊断率,实用性强,值得临床推广。     

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.