浅谈乳腺叶状囊肉瘤与乳腺纤维腺瘤超声影像的相关性及临床意义

乳腺纤维腺瘤发病率在乳腺良性肿瘤中居首位,而乳腺叶状囊肉瘤在临床恶性病变中也并不罕见,有的学者报道与乳腺癌之比可达1∶20.国内有些学者认为,叶状囊肉瘤虽然可以由纤维腺瘤经肉瘤变而成,但是也可能开始时就是肉瘤.本文通过对32例经手术病理证实的病例进行回顾分析,以探讨二者超声影像的相关性及临床意义.     

抽动障碍中医证型与血清单胺类物质的相关性研究

目的 观察抽动障碍不同中医证型患者血清多巴胺、去甲肾上腺素等单胺类神经递质的水平,并探讨各证型之间血清神经递质的水平是否存在差别.方法 采用化学荧光法测定46例抽动障碍患者(病例组)血清多巴胺、去甲肾上腺素水平,并与40例正常儿童(对照组)进行比较.结果 病例组血清多巴胺为0.449μg/ml,对照组为0.210μg/ml;病例组血清去甲肾上腺素为0.227μg/ml,对照组为0.127μg/ml,两组各均值比较,病例组血清多巴胺和去甲肾上腺素均显著高于对照组.病例组外风侵袭、肝风内动型,或兼气郁化火型,或兼脾虚痰聚型,或兼阴虚风动型血清多巴胺水平分别为0.316、0.400、0.235、0.247μg/ml,四者比较有显著性差异;病例组符证型血清去甲.肾上腺素水平分别为0.203、0.224、0.144、0.154μg/ml,四者比较差异有显著性.结论 抽动障碍患者存在多巴胺和去甲肾上腺素水平异常,且各证型血清多巴胺、去甲肾上腺素水平有明显差异,而尤其以外风侵袭、肝风内动兼气郁化火型水平最高.     

神经导航技术在脊柱固定手术中的应用(附16例报告)

目的探索使用神经导航技术进行脊柱内固定。方法在神经导航辅助下,对16例患者置入70根椎弓根(侧块)螺钉。通过术后X线摄片核实椎弓根螺钉置入的准确性。结果置入的70根椎弓根(侧块)螺钉长度和直径选择合适,其中68根(97·1%)固定位置及方向准确;早期曾有1根穿出至椎体前方(<1mm),未作处理;1根穿出至椎间盘,经翻修后固定情况良好。无神经和血管损伤症状。结论使用神经导航技术,可以前瞻性地判断置入椎弓根(侧块)钉的大小、位置,实时监测置入过程,提高置入的准确性和安全性。术中脊柱影像三维重建及注册配准对神经导航的准确性有较大影响。     

脱乙酰壳聚糖-抗坏血酸盐促进腭裂术后愈合的药效学研究

目的 腭裂手术创口是一类不易愈合的创口，为促进腭裂术后创口愈合速度与质量，减少术后复裂率，在腭裂动物模型上对脱已酰壳聚糖的作用进行药效学研究。方法 选20只Wistar大鼠随机分4组，以两种不同术式的实验组与相应的对照组进行实验。术后1、3、5、7、10天分别进行，)盏床观察和组织病理学观察。结果 实验组1，术后1天创面有缺血，3和5天粘膜颜色基本正常，7和10天拆线后的创口均为一期愈合。对照组1，术后1天创面有缺血，3和5天创缘糜烂，7天减轻，10天拆线创口二期愈合。实验组2与其对照组均有显著差异。组织病理，实验组1和组2重建覆盖上皮较对照组出现的早，实验组2缺损断端有新形成的骨组织连接，新骨周边可见成骨细胞，对照组1，有成纤维连接和炎细胞浸润。对照组2，缺损断处有新形成的软骨细胞，有炎细胞浸润。结论 脱已酰壳聚糖对腭裂术后的愈合有较明显的作用，有深入研究和临床应用的价值。     

Health Behavior Correlates of Depression in a Sample of High School Students

Frequency of symptoms of depression and selected health-related practices and events were measured in a sample of 219 high school students. Students reported numerous symptoms of depression. Relative proportions of boys and girls reporting symptoms of depression were not significantly different. However, girls reported experiencing more severe depression than their male counterparts. Depression correlated significantly with several of the 22 health practices and states of affect examined. Both the determinants and manifestations of depression in adolescent cohorts require in-depth investigation. Possible implications for school health personnel are discussed.     

医疗设备管理帐目、资产卡组合的Excel实现

对医疗设备管理帐目、资产卡基本管理模式进行分析和Excel功能比较优选，运用Excel组合功能满足业务流程需要，解决帐、卡分立的现象，达到及时、全面、直观地掌握医疗设备信息的目的。     

慢性硬膜下血肿术后并发症原因分析及应对措施

目的探讨慢性硬膜下血肿（chronic subdural hematoma，CSDH）术后并发症的原因及应对措施。方法回顾2000年至2004年手术治疗的85例CSDH患者，并结合有关文献进行相关分析。结果术后血肿复发3例，张力性气颅1例，脑挫裂1例，硬膜外血肿3例，脑脊液漏1例，脑内血肿1例。结论认识CSDH术后并发症的原因，早期采取有效措施，可有效预防并发症。     

肾功能损伤分级系统在成人心脏术后的应用

Objective The aim of this study was to evaluate of adilty of two acute renal failure-specific scoring systenms (the classification by Bellome et al and the AKIN criteria) for predicting hospital mortality after cardiac surgery in adult patients. Methods Between October 1 st 2006 to Decemjber 31 st 2006, 509 adult patients who ungerwent coronary artery bypass grafting (CABG) and/ or valve operation were enrolled in this study. The medical data collection included gender, age, types of operation, perioperative he- modynamic parameters, urine output, biochemical parameters and outcome. Renal function was assessed daily according to the classi- ficatinn by Bellomo and the AKIN criteria, respectively. As references, Acure Physiology and Chronic Health Evaluation(APACHE) Ⅱ and Sepsis-related Organ Failure Assessment (SOFA) score were also calculated. Resuits Three hundred and forty-one patients were male (67.0%), and 168 were female (33.0%), mean age was (56.2±12.0) years old. Tnree hundred and nine patieats un- derwent CABG, 182 underwent valve operation and 18 underwent CABG plus valve operation, Mean duration of ventilation support was (20.4±17.7) houra, and the ICU stay was (1.4±1.0) days. Postoperative hospital stay was (13.8±9.1) days. According to the classification by Bellomo., the highest in-hospital mortality was 52.9% in ARFS group. Mahiplicatinn of in-hospital morality rate was abserved (X2 for trend, P<0.01) in 0.4% (non-ARF), 1.2% (stage 1), 12.0% (stal～ 2) and 32.4% (stage 3) of pa- tients based on the AKIN criteria. By applying the area under the receiver operating characteristic ourve, the classification by Bellomo and the AKIN criteria had good discriminative power. Furthering, multivariate logistic regression analysis verified that the Odds Ratio of the AKIN criteria was 5.478 (P =0.028, 95% Confidence Interval 1.027- 24.856), after adjusting for gender and age. Con- clusion Analytical data confinned good discriminative power of both the AKIN criteria and the classification by Bellomo for predicting hospital mortality of adult postoperative patient with ARF.     

吸入性损伤犬降钙素的变化

目的单因素观察吸入性损伤或烧伤后血清免疫反应性降钙素(iCT)的变化,分析其诊断意义。方法将24只犬随机分为单纯吸入性损伤后中度(A)、重度(B)、特重度损伤(C)组及单纯重度烧伤(D)组,每组6只。吸人性损伤犬均在伤后6 h行纤维支气管镜检查,以明确其损伤程度。分别于不同时相点抽取犬静脉血检测iCT含量,抽取动脉血做血气分析。结果(1)经纤维支气管镜检查,证实A、B、C组犬符合吸入性损伤的预期程度。(2)与伤前值(38±22)ng／L比较,各组吸人性损伤犬iCT含量在伤后1 h均明显升高(P<0．05),伤后4 h明显高于D组(P(0．05),其中A组于24 h达峰值(453±224)ng／L,B、C组在48 h内呈进行性升高。D组犬iCT含量在伤后2 h开始持续升高,至伤后48 h为(125±41)ng／L。(3)血气分析结果显示,与伤前值(109±8)mm Hg (1 mm Hg=0．133 kPa)比较,A、D两组氧分压(PaO2)伤后各时相点无明显差异(P>0．05),B、C组犬从伤后8 h和伤后4 h开始持续下降,分别为(65±6)、(71±9)mm Hg。与二氧化碳分压(PaCO2)的伤前值(38±5)mm Hg比较,C组犬伤后24 h PaCO2开始升高[(52±11)mm Hg]。结论在吸入性损伤后8 h内,iCT的变化明显早于血气分析指标,其诊断意义接近纤维支气管镜检查。