64层螺旋CT扫描对早期诊断肝癌、局灶性结节增生的特异性及敏感性分析

目的 探讨64层螺旋CT在早期诊断原发性肝癌（HCC）与局灶性结节增生（FNH）中的应用及敏感性、特异性分析。方法 选取2016年1月至2017年1月与我院就诊高度怀疑HCC的56例患者及高度怀疑FNH的45例患者作为可研究对象。所有患者均接受64层螺旋CT平扫及增强扫描，并与术后病理证实结果比较，分析螺旋CT对HCC、FNH早期诊断的敏感性与特异性，并对比二者在CT增强扫描时不同能量水平下的对比噪声比（CNR）情况以及能谱定量参数值情况。结果 64层螺旋CT对HCC早期诊断的敏感性为96.23%，特异性为66.67%，准确性为92.86%；对FNH早期诊断的敏感性为92.68%，特异性为75.00%，准确性为86.67%。增强扫描动脉期时HCC、FNH患者CNR均呈明显的下降状态，并且能量越高则CNR越低，HCC与FNH患者的CNR值比较存在显著差异（P<0.05）；门脉期FNH患者CNR逐渐降低，而在40 keV时获取最佳CNR，HCC患者则表现为CNR先升后降，80 keV时获取最佳CNR，HCC、FNH患者在80~120keV间的CNR值比较存在显著差异（P<0.05），但在40 keV时比较无显著差异（P>0.05）。结论 64层螺旋CT在早期诊断及鉴别诊断HCC、FNH中具有重要的临床价值，检出效能、敏感性、特异性较高，具有临床应用及推广价值。     

Pigmented Mammary Paget Disease Misdiagnosed as Malignant Melanoma

Pigmented mammary Paget disease is a very rare clinicopathologic variant of mammary Paget disease. Diagnosis is often difficult because its clinical and histological features are very similar to those of malignant melanoma. Herein, we report a case of pigmented mammary Paget disease misdiagnosed as malignant melanoma.     

乳腺增生症患者心理状况与人格的归因分析

目的 分析乳腺增生症患者心理状况和人格特征,为提高乳腺增生症患者生活质量提供科学依据.方法 采用SCL-90和16-PF对83例乳腺增生症患者及86例健康对照样本进行测量,应用SAS9.2软件对数据进行统计学处理.结果 （1）研究组在躯体化、强迫、敏感、抑郁、恐怖、偏执因子方面得分较高,差异有统计学意义.（2）多因素非条件Logistic回归分析,结果16-PF乐群、稳定和自律3因子回归系数为负值,而恃强、怀疑、忧虑、紧张4因子回归系数为正值,差异有统计学意义.结论 乳腺增生症患者存在多种心理问题,患者的个性特征对心理问题有显著影响,提醒在对乳腺增生症患者进行治疗时应优化个性结构,改变消极归因模式,普及相关预防性知识,积极改善乳腺增生症患者的心理健康状况.     

Combination of Pitavastatin and melatonin shows partial antineoplastic effects in a rat breast carcinoma model

Our previous results indicated significant tumor-suppressive effects of different statins in rat mammary carcinogenesis. The purpose of this experiment was to examine the chemopreventive effects of Pitavastatin alone and in combination with the pineal hormone melatonin in the model of N-methyl-N-nitrosourea-induced mammary carcinogenesis in female Sprague-Dawley rats. Pitavastatin was administered dietary (10 mg/kg) and melatonin in an aqueous solution (20 μg/ml). Chemoprevention began 7 days prior to carcinogen administration and subsequently continued for 15 weeks until autopsy. At autopsy, mammary tumors were removed and prepared for histopathological and immunohistochemical analysis. Compared to controls, Pitavastatin alone reduced average tumor volume by 58% and lengthened latency by 8 days; on the other hand, the drug increased tumor frequency by 23%. Combined administration of Pitavastatin with melatonin decreased tumor frequency by 23%, tumor volume by 44% and lengthened tumor latency by 5.5 days compared to control animals. The analysis of carcinoma cells showed significant increase in caspase-3 expression in both treated groups and a tendency of increased caspase-7 expression after Pitavastatin treatment alone. Significant expression decrease of Ki67 was found in carcinoma cells from both treated groups. Compared to control carcinoma cells, Pitavastatin alone increased VEGF expression by 41%, however melatonin totally reversed its undesirable effect. Pitavastatin combined with melatonin significantly increased femur compact bone thickness in animals. Pitavastatin alone decreased plasma triglycerides and total cholesterol levels, however it significantly increased levels of glucose. In summary, our results show a partial antineoplastic effect of Pitavastatin combined with melatonin in the rat mammary gland carcinoma model.     

舌异位甲状腺的诊断和治疗

目的：总结舌异位甲状腺的诊断和治疗体会。方法：回顾分析了5例舌异位甲状腺病人的治疗情况。其中3例异位甲状腺全切除术，并行带蒂移植；1例行次全切除，切除的部分正常腺组织行游离移植；1例未予手术给予甲状腺素片口服。结果：4例手术的病人均治愈，服用甲状腺素片的1例病人症状消失，随访两年未复发，结果：术前B超，121I扫描对诊断是必需的。舌体中线切开和颈前舌骨上进路，带蒂移植是较为合理的方法。     

经尿道汽化与电切治疗前列腺增生症

目的 探讨经尿道汽化与电切联合治疗良性前列腺增生症（ＢＰＨ）的临床效果。方法 观察术中出血量、手术时间、电切综合症，比较手术前后前列腺症状评分（ＩＰＳＳ）、生活质量（ＱＯＬ）、最大尿经Ｑｍａｘ和术中、术后并发症。结果 本组４５例，平均年龄６９岁，病程６年，平均手术时间６０ｍｉｎ，术中出血５０ｍｌ，术后留置导水管３－７ｄ，术后ＩＰＳＳ〉ＱＯＬ、Ｑｍａｘ明显改善，电切综合征ＴＵＲＳ１例（２．２％），３     

隆乳术后纤维囊挛缩机制研究进展

回顾近五年有关隆乳术后纤维囊挛缩的文献，归纳为五个方面：１．挛缩的评价方法：包括体内与体外测量，以影像学的图象处理为判断挛缩的趋势；２假体的化学构成与挛缩的关系：多数文献认为挛缩与硅胶弥散无关，聚胺酯表面假体抑制挛缩的机制在于其表面粗糙；３．假体表面物理性状与挛缩的关系：临床结果与一些动物实验结果存在差异；４挛缩的动力学环境：挛缩的动力在于成纤维细胞转化为肌成纤维细胞，动力学环境的改变包括胶原纤维和透明质酸的变化，并与细胞因子调控有关；５挛缩的预防和治疗：主要通过改变假体表面的理化性质和药物应用。     

A monoclonal antibody that detects myoepithelial cells in exocrine glands,basal cells in other epithelia and basal and suprabasal cells in certain hyperplastic tissues

Summary Myoepithelial and luminal cells of human exocrine glands can be positively identified with two different monoclonal antibodies. Myoepithelial cells including those of the salivary gland, mammary gland and sweat gland are positively identified by an antibody CKB1. This antibody does not stain luminal cells, but stains the basal cell layer of certain human stratified epithelia and a few basal cells in simple epithelia. Thus myoepithelial cells and basal cells have certain common features. Luminal cells can be positively stained with the CK5 monoclonal keratin antibody specific for keratin polypeptide 18; this antibody does not stain myoepithelial cells. Of interest is that CKB1 also appears to stain basal and suprabasal cells in certain hyperplastic conditions.Dedicated to Prof. Dr. F.H. Caselitz on the occasion of his 65th birthdaySupported by grants from the Deutsche Forschungsgemeinschaft and the Hamburger Stiftung zur Förderung der Krebsbekämpfung to J.C. and from the Deutsche Krebshilfe to M.O.     

SP1,EMA,CEA和KT在乳腺结构不良和腺纤维瘤内的表达

本文观察了SP_1、EMA、CEA和KT在乳腺结构不良和腺纤维瘤内的分布情况.结果表明上述标志的表达具有显著的不均一性,使得评估这些标志的意义变得困难.SP_1对鉴别乳腺良恶性病变有价值.但其余标志的表达情况各作者的结果不一致,本文指出其原因和今后研究的方向.