高频超声对乳腺肿块微钙化的检测及临床意义

目的 探讨高频超声对乳腺肿块微钙化的检测及其临床意义.方法 选取96例乳腺肿块伴微小钙化患者,术后病理检查确诊为良性肿瘤50例（良性组）,恶性肿瘤46例（恶性组）,通过高频超声探查显示钙化灶的分布与特点并比较两组的区别,同时探讨患者年龄与微钙化的关系.结果 两组均以微钙化多见,良性组34例（68.00％）,恶性组44例（95.65％）,恶性组的微钙化所占比例明显高于良性组,经比较差异有统计学意义（x2=12.0252,P=0.001）.其中良性组的微钙化灶多呈散点状分布,而恶性组的微钙化灶多呈簇状分布,组间比较差异有统计学意义（x2值分别为12.5458,37.4088,P＜0.001）.良性组的粗钙化所占比例与恶性组相似（x2=2.3490,P=0.1254）,弧形钙化所占比例明显高于恶性组（x2=8.029,P=0.005）.良性组的微钙化者以＞45岁居多,而恶性组的微钙化以≤45岁者为主,两组比较差异有统计学意义（x2=6.0711,P=0.0137）.结论 高频超声能够有效显示乳腺肿块内钙化的类型,有助于乳腺良恶性肿块的鉴别诊断.     

微钙化灶在乳腺癌超声诊断中的价值

目的探讨高频超声检测乳腺肿块内微钙化灶在乳腺癌诊断中的应用价值。方法对112例合并钙化的乳腺肿块患者进行高频超声检测,重点观察肿块内钙化灶大小、形状、数目及分布特征,以术后病理为诊断“金标准”,比较分析乳腺肿块内不同钙化类型与肿块良恶性之间的关系。结果术后病理证实：112例肿块中恶性79例,良性33例。乳腺恶性肿块合并钙化(70.54%,79/112)较良性肿块合并钙化(29.46%,33/112)多见;恶性肿块微钙化发生率(92.41%)明显高于良性肿块(30.30%)。恶性肿块微钙化以簇状分布为主(69.86%)。微钙化灶诊断乳腺恶性肿瘤的敏感度为92.41%。结论高频超声能有效显示乳腺肿块内部微钙化灶类型,呈簇状分布的微钙化灶是高频超声诊断乳腺癌的重要指标。     

乳腺肿块内钙化高频超声影像学特征分析

目的:分析乳腺肿块内钙化的高频超声影像学特征。方法:选取50例乳腺肿块患者,以病理检查结果为"金标准",对高频超声检查准确性及乳腺肿块内钙化影像特征进行评价分析。结果:50例患者经病理检查确诊为乳腺良性肿块16例,恶性肿块34例;超声检查诊断为乳腺良性肿块18例,恶性肿块32例。2例恶性肿块超声检查误诊为良性肿块,超声检查准确率为96.0%。恶性肿块微钙化发生率明显较良性肿块高,差异具有统计学意义(P<0.05)。良性肿块粗大钙化较恶性肿块多见(P<0.05)。良性肿块以单一或散在分布钙化灶多见(13/16),恶性肿瘤以团簇状钙化多见(21/34)。结论:高频超声显示乳腺肿块内钙化具有较高的敏感性,良性肿块以粗大钙化多见,多单一或散在分布;恶性肿块以微小钙化多见,多呈簇状分布。     

高频超声对乳腺肿块内钙化的诊断价值

目的应用高频超声观察乳腺肿块内钙化特点,进一步探讨其与肿块良恶性之间的关系。方法 99例高频超声检查具有钙化灶的乳腺肿瘤患者,术后病理为恶性肿瘤（乳腺癌）59例,良性40例,将超声所见与病理结果进行对照。结果根据钙化大小及形状,将病变内钙化分为微钙化、粗钙化和弧形钙化三类。根据微钙化的分布特点将其分为散点状钙化和簇状钙化两类。59例恶性病变,其中微钙化57例,粗钙化2例;40例良性病变中,微钙化26例,粗钙化7例,弧形钙化7例,微钙化多发生在恶性病变中,而粗钙化和弧形钙化多出现于良性病变中。恶性肿块微钙化多呈簇状分布,良性肿块微钙化多呈散点状分布。结论高频超声可以有效地检出并识别乳腺内的钙化灶,超声显示簇状分布微钙化灶对乳腺癌的诊断具有很大价值。     

超声探测乳腺肿块内钙化特征的临床意义

[摘要] 目的 回顾性分析超声观察的乳腺肿块内钙化的大小、形状和分布特征,探讨其在乳腺肿块良恶性鉴别的意义。方法 87例高频超声检出钙化灶的乳腺肿块患者,全部经手术切除和病理检查,其中各种类型乳腺癌67例,良性病变20例。结果 67例乳腺癌病变中,微钙化62例,粗钙化5例。良性乳腺疾病20例中,微钙化11例,粗钙化5例,周边钙化4例。微钙化多发生于恶性病变中,而粗钙化和弧形钙化则多出现于良性病变中 (x2=13．41,P相似文献   

高频超声有效检出乳腺肿块内微钙化灶的研究

目的研究高频超声是否能有效地检查出乳腺肿块内微钙化灶。方法选择我院2010年11月。2012年12月收治的乳腺肿块的患者147例,使用高频超声对患者进行检查;并乳腺钼靶检查的乳腺肿块患者的检查资料进行分析,所有患者都经病理检查。根据各组的病理检查结果对比两种方式对乳腺肿块内微钙化灶的检出率。结果147例患者中乳腺钼靶检查显示乳腺肿块内微钙化灶62例。高频超声检出单发或多发直径〈1mm针尖样强回声108个（73．5％）。其中包括96个恶性病变和12个良性病变的微小钙化灶,而96个恶性病变中有81个（84．4％）多发钙化,12个良性病变的微小钙化灶5个（41．7％）多发钙化,钼靶乳腺摄影诊断出62例,检出率为42．18％,高频超声诊断出108例,检m率为73．47％。两组比较差异具有统计学意义（χ^2=9．51,P〈0．01）。结论高频超声对乳腺肿块内的微钙化灶能有效地进行检出。     

彩色多普勒显像及微钙化灶的超声显示对乳腺肿块的评价

目的　探讨彩色多普勒显像及微钙化灶的超声显示对乳腺肿块鉴别诊断中的价值。方法　我们对 2 0 0 2 - 0 1～ 2 0 0 3- 0 6间经手术病理证实的 10 2例乳腺肿块超声扫查资料进行分析 ,重点讨论彩色多普勒血流及微钙化灶在不同大小良、恶性肿块内的显示状况。其中 ,恶性肿瘤 4 6例 ,良性肿块 5 6例。本组分别对不同病理类型乳腺肿块血流显示率、不同直径乳腺良、恶性肿块血流信号检出率及血流丰富程度、脉冲多普勒检测结果Vmax、RI值、不同直径良恶性肿块内微钙化灶超声显示情况进行对比分析。结果　不同病理类型乳腺肿块血流显示率无明显差别 ,乳腺恶性肿瘤血流信号检出率明显高于良性肿块 ,≤ 2cm乳腺恶性肿瘤血流信号检出率明显高于良性肿块 ,>2cm乳腺良、恶性肿块血流信号检出率无明显差异 ,恶性乳腺肿瘤较良性肿块血流信号丰富 ,乳腺恶性肿瘤呈高速高阻型 ,RI值偏高。乳腺良性肿块呈高速低阻型 ,RI值偏低 ,>2cm乳腺恶性肿瘤微钙化灶显示率明显高于良性肿块 ,<2cm良、恶性肿块微钙化灶显示率无明显差异。结论　二维声像图结合彩色多普勒和脉冲多普勒综合应用是诊断乳腺肿块的首选方法 ,对于≤ 2cm乳腺肿块 ,彩色多普勒血流显像在鉴别肿块良恶性有诊断价值 ,>2cm乳腺肿块微钙化灶的显示对乳癌有诊断价?     

高频超声在良恶性乳腺疾病微小钙化灶诊断中的应用价值

目的探讨高频超声在良恶性乳腺疾病微小钙化灶诊断中的应用价值。方法回顾性分析经病理确诊的96例乳腺疾病患者的临床资料,其中良性乳腺疾病57例分为良性组,恶性乳腺疾病39例为恶性组。比较两组患者微小钙化灶的特征。结果良性组微小钙化灶形态以圆或椭圆形为主(75.44%),恶性组以不规则形态为主(84.62%),两组形态构成比较,差异有统计学意义(P0.05);良性组微小钙化灶边界清晰者为87.72%,明显高于恶性组的17.95%,两组比较,差异有统计学意义(P0.05);良性组经超声显示内部钙化率为42.11%,明显低于恶性组的82.05%,两组比较,差异有统计学意义(P0.05);良性组无钙化者为52.63%,明显高于恶性组的10.26%,两组比较,差异有统计学意义(P0.05)。结论良性乳腺疾病与恶性乳腺疾病相比,其微小钙化灶形态大部分为圆形或椭圆形、边界清晰、内部回声均匀,利用高频超声能有效检出乳腺内微小钙化灶,对乳腺癌的诊断有重要临床价值。     

超声显示钙化灶对甲状腺良恶性结节鉴别的临床意义

目的 探讨甲状腺彩色多普勒超声图像中的钙化灶对甲状腺结节良恶性鉴别的临床意义.方法 对347例行甲状腺手术患者的病理检查结果 与其术前甲状腺彩色多普勒超声图像进行回顾性比较研究.结果 病理检查结果 显示,甲状腺恶性结节102个(恶性组),良性结节384个(良性组).恶性组钙化灶及微钙化灶构成比分别为69.6%(71/102)、45.1%(46/102),均显著高于良性组的18.5%(71/384)、1.0%(4/384,P值均＜0.01).去除性别因素后,≤45岁亚组中恶性甲状腺结节的钙化灶构成比为81.6%(31/38),微钙化灶构成比为68.4%(26/38),均显著高于＞45岁亚组[62.5%(40/64)、31.2%(20/64),P值均＞0.01].结论 彩色多普勒超声图像中的钙化灶是甲状腺癌的一项特异性指标,一旦超声检查发现甲状腺内有钙化灶,尤其是微钙化灶,年龄＜45岁且伴较大结节者,应该高度警惕癌变风险.     

高频超声在乳腺良性肿块与乳腺癌鉴别诊断中的应用价值

目的探讨高频彩色多普勒超声在乳腺良性肿块与乳腺癌鉴别诊断中的应用价值。方法选择经病理证实的39例乳腺良性肿块(良性组)与28例乳腺癌(恶性组)行高频彩色多普勒超声检查,分析比较良性肿块与乳腺癌的二维及彩色多普勒血流图像,探讨高频彩色多普勒超声在乳腺良性肿块与乳腺癌鉴别中的应用价值。结果良性组中形态规则73.68%(28/38),恶性组中形态规则24.13%(7/29);良性组中边界清晰68.42%(26/38),恶性组中边界清晰20.69%(6/29);良性组中肿瘤纵横比>1者10.53%(4/38),恶性组中纵横比>1者65.52%(19/29);良性组中出现沙砾样钙化5.3%(2/38),恶性组中出现沙砾样钙化41.38%(12/29);良性组中后方回声衰减18.42%(7/38),恶性组中后方回声衰减82.76%(24/29)。以上结果良恶性组间差异均有统计学意义(P<0.05)。良性组中出现血流信号者52.63%(20/38),恶性组中出现血流信号者65.52%(19/29),两组间差异无统计学意义(P>0.05)。良性组中出现穿支血流者10.53%(4/38),恶性组中出现穿支血流者58.62%(1...     

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.     

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.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.