超声弹性成像在乳腺疾病的临床应用

超声弹性成像能够获得组织内部的弹性分布的定量信息,具有重要的临床价值和广阔的应用前景.除可应用于乳腺疾病外,还可广泛应用于前列腺癌检测、肝纤维化诊断、热治疗监测等方面,本文详细论述了弹性成像在乳腺疾病外的临床应用.     

超声造影与超声弹性成像在甲状腺良恶性结节诊断中的应用价值

目的 观察超声造影与超声弹性成像诊断及鉴别甲状腺良、恶性结节的临床价值.方法 甲状腺结节患者120例(150个结节)分别采用超声影像及超声弹性成像实施诊断,统计超声造影、弹性成像诊断准确率、敏感度、特异度、阳性预测值、阴性预测值.结果 超声造影64个恶性结节中,诊断为恶性者59个,占92.2％;良恶性结节造影剂分布及增强时相情况比较,差异显著(P＜0.05).超声弹性成像86个良性结节中,Ⅰ或Ⅱ级表现者80个(93.0％),Ⅲ～Ⅳ级表现者6个(7.0％);64个恶性结节中,Ⅲ～Ⅳ级表现者58个(90.6％),Ⅰ或Ⅱ级表现者6个(9.4％);良性结节的超声弹性成像分级比较差异显著(P＜0.05).超声造影联合超声弹性成像检查显著优于单项检查(P＜0.05).结论 应用超声造影、超声弹性成像在诊断及鉴别甲状腺良恶性结节方面均具有重要价值.     

弹性成像在乳腺占位性疾病诊断中的应用

目的 乳腺占位性疾病发病率逐年上升,早发现,早诊断对防治乳腺占位性疾病至关重要,而弹性成像应用对乳腺占位性疾病诊断具有很重要的参考价值.方法 随访乳腺占位性疾病患者50例(56个病灶)作为研究对象,对其进行普通超声检查及弹性成像检查,其中良性50例,恶性6例.结果 弹性成像检查提高了乳腺占位性疾病的良恶性诊断.     

超声弹性成像在乳腺肿块诊断中的应用价值探讨

目的 探讨超声弹性成像在乳腺肿块诊断中的应用价值.方法 选取2011年至2012年间我院治疗乳腺肿块的患者47例为研究对象.所有研究对象均行超声弹性成像检查,并将超声结果与手术病理结果相比较,从检查的敏感性、特异性以及准确率方面,评价超声弹性成像在乳腺肿块诊断中的应用价值.结果 超声弹性成像对恶性病变的感性为80.00％,特异性为91.89％,准确率为89.36％.结论 超声弹性成像用于乳腺肿块的诊断,可以清晰地描述肿块的大小、形态、数目以及边缘等,并对肿块的良恶性进行判断.     

实时超声弹性成像在乳腺疾病包块诊断中的应用价值分析

目的 探讨我院自2009年12月～2011年12月利用实时超声弹性成像对诊断乳腺疾病良恶性方面的应用价值.方法 对2009年12月～2011年12月,83例患者120个乳腺疾病灶进行常规超声检查以及实时弹性成像的检查,利用实时弹性成像5分评分法,对弹性成像结果与手术病理结果进行对照分析.结果 恶性肿块45个,弹性成像评分.结论 1分1个；2分3个,3分5个,4分24个,5分12个.     

超声弹性成像基本原理及技术

超声弹性成像通过获取有关组织弹性信息进行成像,被广泛应用于临床,成为目前医学弹性成像的一个研究热点。本文介绍了血管内超声弹性成像、组织超声弹性成像的基本原理,以及各种弹性成像技术方法。     

生物组织弹性测量：技术、仪器和应用

在临床上,可以通过用手触诊去感知某些组织的硬块来作出一些初步的诊断,例如乳腺癌的早期诊断。但是这种手触诊技术只能给出定性的结果,该结果依赖于操作者的经验,所以带有很大的主观性,于是能让诊断结果更加客观化的弹性成像和测量技术应运而生。弹性成像和弹性测量技术各有不同特点：弹性成像往往给出成像区域里面的弹性对比度而不必给出组织的本征参数;不同于弹性成像,弹性测量技术能给出组织弹性的本征参数例如杨氏模量等,有利于诊断某些弥漫性的组织疾病,例如肝硬化,并且跟踪组织的弹性随时间的变化情况,而且结果的比较不会受制于所使用的测量仪器。因此,伴随着各种医学成像技术,例如超声、核磁共振成像（MRI）和光学成像的广泛普及,针对活体组织的弹性测量学在最近的二三十年里得到了长足的发展,诞生了很多新的测量技术和仪器,并且部分已经开始用于临床测试。可以预见,随着这些测量技术的发展和进步还将有源源不断的新的测量技术诞生,将会有越来越多的临床领域开始尝试或者大力普及通过弹性测量的方法来补充现有的一些不太完善的诊断方法,或者用来评估治疗方法的有效性。本文尝试给读者介绍一些传统和近来出现的弹性测量的技术和系统,然后简要介绍它们在诊断特定组织病变和评估治疗方法疗效方面的应用,最后我们对此领域的未来研究方向和前景作一些展望。对于其中比较成熟的几种方法,我们会在这一期刊的随后几期作详细的介绍。     

超声造影和超声弹性成像在甲状腺良恶性结节鉴别诊断中的临床价值

目的:旨在探究超声造影和超声弹性成像在鉴别甲状腺良恶性结节的临床价值.方法:随机抽取我院2016年8月-2017年9月期间收治的78例确诊为甲状腺结节性病变患者作为本次的研究对象,全部患者在术前均给予常规超声、超声造影和超声弹性成像的检查,结合病理诊断的最终标准,综合分析两种检查手段的诊断准确率、敏感性、特异性、阳性预测值及阴性预测值的情况.结果:超声造影和超声弹性成像在鉴别诊断甲状腺良恶性结节方面与常规超声比较,具有较高的检出率,在敏感性、特异性、阳性预测值及阴性预测值方面均由于常规超声,(P<0.05),差异有统计学意义.结论:使用超声造影和超声弹性成像技术应用于甲状腺良恶性结节鉴别中具有显著的临床成效,通过从不同角度提供诊断信息,极大地提高了诊断精准率,值得临床的推广和借鉴.     

超声弹性成像基本原理及临床应用

超声弹性成像技术能够获得组织内部的弹性分布的定量信息,是医学超声成像的热点,被称为继A型、B型、D型和M型之后的E型模式,具有广泛的临床应用前景。本文介绍了超声弹性成像的基本原理、超声弹性成像的三种技术以及超声弹性成像的分类及临床应用。     

超声弹性成像对乳腺肿块的早期诊断价值

目的:探讨超声弹性成像对乳腺肿块的早期诊断价值.方法:对140例患者(共154个病灶)进行常规超声和超声弹性成像检查并与患者手术病理诊断结果做对照,比较两种检查方法诊断的总符合率.结果:常规超声诊断乳腺恶性肿瘤的灵敏度为62.75％,特异度为74.79％,诊断的总符合率为69.48％,而超声弹性成像诊断乳腺恶性肿瘤的灵敏度为86.27％,特异度为91.26％,诊断的总符合率为89.61％,明显高于普通超声诊断的总符合率,差异具有显著性意义(P＜0.05).结论:超声弹性成像对乳腺肿瘤的早期诊断和早期治疗有一定临床意义,在乳腺癌的早期预防中有重要意义.     

A comparison of educators' and providers' rankings of the important competencies for day care professionals

The most important competencies for directors and teachers were identified from educators' and providers' rankings. Personal qualities and staff relations were important for directors, while promoting children's emotional development and the teacher's personal qualities were important for teachers. Educators and providers agreed more about the competencies important for teachers than for directors.The data analyzed in this paper were collected as part of the second author's master's thesis submitted to Colorado State University.     

Identification of agricultural tasks important to cumulative exposures to inhalable and respirable dust in California

Little data exists on the determinants of agricultural dust exposure, particularly in dry climates. Annual exposure indices to inhalable and respirable dust were constructed by exposure estimates for specific tasks, task duration, and task frequency. The estimates of exposure levels were based on actual field measurements and subjective dust exposure ranking. The task duration and frequency data were obtained by questionnaire from 546 farm operators in California. Annual exposure indices were analyzed to determine which tasks were major contributors to chronic dust exposure. The important tasks were identified by comparisons of the cumulative distribution of exposures for all tasks and the cumulative distribution of exposures with one task deleted. Thirteen and 11 tasks were identified to be important to both inhalable and respirable dust exposures, respectively. Tasks identified to be important to agricultural exposure may be ascribed to exposure duration more than to exposure intensity. Information on task-specific exposure is important for developing control strategies in the agricultural workplace.     

Personal values of male and female doctors: gender aspects

The aim of this study was to elucidate the personal values of physicians. It was part of the Physician 93 Study, the purpose of which was to shed light on the life situation, career and future plans of young doctors and their views on medical education. The survey population included all the medical doctors registered during the years 1982-1991 in Finland (N = 4671). In the spring of 1993 a postal questionnaire was sent to a random sample of 2341 doctors. After two reminder letters, 1818 questionnaires (78%) were returned. 59% of the respondents were women. Subjects were asked to rate on a 4-point scale each of a set of 17 potentially important values listed in the questionnaire, five of which were seen by the majority of physicians as very important. These values were: family life, health, close friends, success in work or in studies and children's success. The potentially important values were conceptualized as indicative of eight important dimensions of the values of physicians: close friends, health. self actualization, success, universal values, well-being, family and ideology. Women doctors rated close friends, health, success, universalism and ideology as more important than men doctors.     

Sources influencing patients in their HIV medication decisions.

The authors surveyed 202 patients (54.5% male; 62.4% African American) enrolled at St. Louis HIV clinics to identify the importance of various sources of influence in their HIV medication decisions. Physicians were the most important source for 122 (60.4%) respondents, whereas prayer was most important for 24 respondents (11.9%). In multivariate tests controlling for CD4 counts, Caucasian men were more likely than Caucasian women and African Americans of both genders to select a physician as the most important source. African Americans were more likely than Caucasians to mention prayer as the most important source. Caucasians and those rating physicians as the most important source were more likely to be using antiretroviral medications. Respondents identified multiple important influences-hence the potential for conflicting messages about HIV medications. These findings have implications for health education practices and behavioral research in the medical setting.     

Communication in general practice: differences between European countries

BACKGROUND: Based on differences in national health care system characteristics such as the gatekeeping role of GPs (at the macrolevel) and on diverging GP and patient characteristics (at the microlevel), communication may differ between countries. Knowledge of the influence of these characteristics on doctor-patient communication will be important for setting European health care policies. OBJECTIVES: Our objectives were (i) to compare doctor-patient communication in general practice between European countries; and (ii) to investigate the influence of the gatekeeping system and GP and patient characteristics on doctor-patient communication in general practice. METHODS: Fifteen patients per GP (in total 2825 patients) of 190 GPs in six European countries were included. Participating countries were The Netherlands, Spain, the UK (gatekeeping countries), Belgium, Germany and Switzerland (non-gatekeeping countries). Data were collected by means of patient and GP questionnaires and observation of videotaped consultations, and analysed by one-way and multilevel, multivariate analysis. RESULTS: Differences in communication between countries were found in: affective and instrumental behaviour; biomedical and psychosocial talk; GPs' patient-directed gaze; and consultation length. The study showed that GPs' gatekeeping role (with registered patients) was less important for doctor-patient communication than was expected. Patient characteristics such as gender, age, having psychosocial problems, and familiarity between the doctor and the patient were the most important in explaining differences in communication. CONCLUSION: The gatekeeping role of GPs is hardly important in explaining doctor-patient communication. The relationship is more complex than expected. Patient and GP characteristics are more important. Cultural factors should be included in future studies.     

Studying the etiology of deafness in the "deaf" schools of Alexandria

Two hundred and twenty three children with childhood deafness were included in this study. They were collected randomly from pupils of Al-Amal schools for the deaf in Alexandria. They were subjected to complete audiological examinations. One hundred and three cases had genetically determined deafness, 12 cases were due to prenatal causes, 20 cases to perinatal causes, 45 cases to postnatal causes, and 43 cases with undefined etiology. One hundred and ninety cases had prelingual deafness, 25 cases had perilingual deafness, and only 8 cases had postlingual deafness. Consanguinity with positive family history for deafness was found to be the most important factor in the genetically determined deafness. Rubella was the most important prenatal cause, while perinatal hypoxia was the most important perinatal cause, and meningitis was the most important postnatal cause. The results were compared with another study that was conducted 25 years ago in the same schools. The comparison was done in view of the changes that occurred in the Egyptian society in the last quarter of a century.     

165例无症状性心肌缺血的动态心电图分析

目的探讨动态心电图对无症状性心肌缺血的诊断价值。方法应用Holter对165例无症状性心肌缺血患者记录日常生活活动并进行分析。结果 165例冠心病患者中共检出缺血性sT段改变589阵次,其中471阵次（80%）属无症状性心肌缺血,而有症状发作118阵次（20%）。SMI发作时间大多集中在06：00-10：00,占60%;16：00-17：00,占30%;其他时间占10%。结论 Holter是评价SMI的重要工具,能明确心律失常的种类、心肌缺血发作次数、持续时间和演变规律,可为临床早期诊断提供重要依据。     

哈尔巴岭重要医学动物及防制对策

目的调查吉林省敦化市哈尔巴岭的重要医学动物的种类,制定防制对策。方法采用夹日法捕鼠;帐诱、灯诱和挥网采集吸血双翅昆虫;布旗法采集自然环境中的蜱。结果在吉林省敦化市哈尔巴岭采获重要医学动物11 804只,计8科20属59种,其中鼠类3科7属9种,食虫类1科1属1种,蚊科3属10种,蠓科1属7种,虻科5属28种,硬蜱科3属4种。优势种:黑线姬鼠(37.2%),大仓鼠(32.7%);刺扰伊蚊(81.0%);新替库蠓(47.3%),刺螫库蠓(23.6%);显著瘤虻(28.5%),窄须瘤虻(12.8%);嗜群血蜱(69.5%),全沟硬蜱(17.4%)。不同月的重要种群组成有所不同。结论此研究为吉林省敦化市哈尔巴岭重要医学动物的种群组成和防制提供了依据。     

计划移植技术在肺癌二程加量放疗中的应用探讨

目的：探讨计划移植技术在肺癌二程加量放疗中的应用。方法：选择某医院6例肺癌二程加量放疗患者,将一程放疗计划移植到二程CT扫描图像中,生成一个新的计划,评估新计划各相关重要器官的受照射剂量,并与一程计划结果相比较。结果：2个计划的射野参数相同,但重要器官（双肺、心脏）受照射剂量却有较大差别。结论：在肺癌患者肿瘤体积缩小后,各相关重要器官受照射剂量也发生了较大改变。利用计划移植技术可以实现个体化的分析,从而为二程加量放疗的处方剂量和计划设计提供参考。     

广藏列车乘客身体症状感觉的影响因素分析

目的了解广藏列车运行区间乘客身体症状感觉,并探讨其影响因素。方法列车运行在不同海拔高度时对列车车厢环境进行空气质量监测,在同一时段相应车厢内对部分乘客进行身体主观感觉调查。结果乘客出现头痛感觉的占34．4％,氧含量与其呈负相关,噪声与其呈正相关。乘客中出现喉咙干痒感觉的占51．5％,风速和湿度与其呈负相关。出现胸闷感觉的占60．8％,风速和湿度与其呈负相关,CO2浓度与其呈正相关。结论氧含量、风速、湿度、CO2浓度是广藏列车乘客身体症状感觉的重要影响因素。