Breast Elastography: How to Perform and Integrate Into a “Best-Practice” Patient Treatment Algorithm

Breast elastography has been available for more than 15 years but is not widely incorporated into clinical practice. Many publications report extremely high accuracy for various breast elastographic techniques. However, results in the literature are extremely variable. This variability is most likely due to variations in technique, a relatively steep learning curve, and variability in methods between vendors. This article describes our protocol for performing breast elastography using both strain elastography and shear wave elastography, which produces high sensitivity and specificity. Additionally, we will describe the most commonly known false-positive and false-negative lesions as well as how to detect them.     

实时剪切波弹性成像在拉米夫定治疗乙肝纤维化过程中的疗效评估作用

目的探讨实时剪切波弹性成像在评估拉米夫定治疗乙肝纤维化临床疗效中的作用。方法选取2017年1月～2018年1月我院收治的80例乙肝纤维化患者,根据随机数字法分为对照组和观察组,每组40例。对照组采用常规治疗,观察组在对照组的基础上给予拉米夫定进行治疗,治疗6个月。比较两组治疗前后肝功能、肝纤维化指标,利用实时剪切波弹性成像评估两组治疗前后肝脏弹性模量值及肝穿刺活检情况,并进行比较。结果两组治疗后AST、ALT、TBIL水平均明显低于治疗前,差异有统计学意义(P0.05);观察组治疗后AST、ALT、TBIL水平均明显低于对照组,差异有统计学意义(P0.05);两组治疗后HA、LN、PⅢPN-P、CL-Ⅳ水平及杨氏弹性模量值均显著低于治疗前,差异有统计学意义(P0.05);观察组治疗后HA、LN、PⅢPN-P、CL-Ⅳ水平及杨氏弹性模量值均显著低于对照组,差异有统计学意义(P0.05);与治疗前相比,两组治疗后肝穿刺活检结果均有好转,尤其是汇管区、肝小叶内炎症及肝纤维化改善明显。结论实时剪切波弹性成像作为肝脏硬度定量检测的无创性技术,可用于拉米夫定治疗乙肝纤维化临床疗效评估的重要方法。     

前循环缺血性卒中老年患者颈动脉斑块及其稳定性与血流壁切应力的关系

目的通过探讨前循环缺血性卒中老年患者颈总动脉分叉处血流壁切应力的水平分析其在颈动脉斑块形成过程中的影响。方法本研究选择前循环缺血性卒中老年患者,应用经皮血管彩超测量颈动脉斑块及其稳定性以及对研究对象测量患侧颈动脉血流速度、血管内径和血液粘滞度,通过公式计算血流壁切应力。结果无斑块组和有斑块组之间、高回声和低回声斑块组之间血流壁切应力均有显著性差异(P<0．01)。结论血流壁低切应力促进颈动脉斑块、尤其是不稳定斑块的形成。     

凉粉草胶稀溶液的性质

研究了凉粉草胶多糖在20-40℃之间特性粘度对温度的敏感性，计算得其稀溶液的临界线团交叠值C^＊[η]平均为1．13，半稀释区斜率b为0．8～1．2，与其他多糖进行了比较。结果表明：凉粉草胶多糖的特性粘度在所测温度区域内的变化不敏感；凉粉草胶多糖在水溶液中，分子链构象可能为刚性杆状结构。     

慢性肺心病哮喘持续状态218例临床分析

目的探索治疗慢性肺心病哮喘持续状态的方法。方法回顾性分析1983年10月～2005年3月收治的218例慢性肺心病哮喘持续状态患者的临床资料。结果哮喘持续状态在48h以内被控制的62例（28．4％）；在72h以内控制的56例（25．7％）；在120h以内控制的25例（11．5％）；在168h以内控制的34例（15．6％）；痊愈出院177例（81．2％）；死亡41例（18．8％）。结论（1）治疗慢性肺心病哮喘持续状态．根据患者的病理变化．综合治疗．效果显著。（2）在治疗过程中．要恰当选择抗生素和平喘药；对那些血液黏滞度增高的患者．要加用血液稀释疗法。（3）测定血液黏滞度和氧饱和度．可以指导治疗、估计预后．应当列为常规检查。     

抑制脑血栓形成的硫代磷酸酯脱氧寡核苷酸的亲和性研究

目的为抑制脑血栓形成,合成与TF基因启动子区切应力反应元件(SSRE)形成三链DNA的硫代磷酸酯寡核苷酸(TFO)。方法设计TFO序列14条,采用固相亚磷酰胺三酯固相法合成TFO。硫代磷酸酯修饰在TFO的3'末端进行。应用电泳迁移分析(EMSA)观察寡核苷酸和硫代脱氧寡核苷酸的亲和性。结果在设计合成的14条寡核苷酸中,与靶序列能形成三链DNA的TFO只有T21GTa、T14GTa和T15GTa,其Kd值分别为3.6×10-10、1.0×10-9和1.0×10-8(M),经硫代磷酸酯修饰后分别为:2.3×10-9、3.8×10-9和1.5×10-8。结论硫代磷酸酯修饰的T21GTa-ps、T14GTa-ps和T15GTa-ps能够与TF基因启动子SSRE的3个位点形成三链DNA。     

应用电子计算机计算血液流变学的正常值及分析

为评价血流粘滞诸因素生理与病理的异常,对济南地区338例正常人血液流变学的各项指标进行了检测,统计了血液流变学各项指标的总平均及男女的平均值和正常范围,并计算了血液流变学各项指标间的相关系数。     

Improved haemorheology associated with a reduction in plasma fibrinogen and LDL in patients being treated by heparin-induced extracorporeal LDL precipitation (HELP)

Heparin-induced Extracorporeal LDL-Precipitation (HELP) is an effective procedure for the elimination of both plasma LDL and fibrinogen. In 10 adult patients with severe type II hyperlipoproteinemia, a single HELP treatment of 3 1 plasma led to an acute decrease in the average plasma viscosity (PV) from 1.30 to 1.1 mPas. At the same time, an even more marked decrease in the mean erythrocyte aggregation rate from a pathological value of 7.9% to a value of 3.7% (normal range less than 5%) was observed. Long-term studies on five patients demonstrated a lasting improvement in these two haemorheological variables. The acute rheological changes were also accompanied by an improvement in polarographically determined muscle oxygen tension. Mean oxygen tension values measured in both the m.biceps brachii and the m.tibialis anterior in five patients before and after a single HELP treatment increased from 30 +/- 4 to 37 +/- 7 mmHg and from 27 +/- 2 to 31 +/- 3 mmHg respectively. These results may provide an explanation for the rapid improvement in patients' clinical symptoms such as angina pectoris and in stress electrocardiogram which have been observed during HELP therapy.     

Effects of Phentolamine on Hemorrheology and Hemodynamics in Dogs with Acute Liver Damage

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