扎实开展经门静脉途径介入诊疗工作

随着介入器材发展和操作技术的熟练,肝脏门脉系统介入诊疗工作有很大发展。欲进一步发挥介入诊疗的优点,必须认真复习门脉系统的解剖结构和正常变异,熟悉门脉的病理解剖,发掘介入器械、栓塞剂的新用途,扎实开拓门脉介入诊疗领域的研究。     

部分NANDA护理诊断缺陷分析及对策

NANDA护理诊断给中国护理带来了巨大进步,但在教学和临床应用时,有些护理诊断名称与医学名词相同而内涵不同,有些护理诊断缺乏定量判断而不够严谨,有些护理诊断概念不同但诊断依据和护理措施几乎类似,有些疾病的主要症状体征没有相应的护理诊断。改进护理诊断的对策:一是继续提升对护理诊断的认识,护理诊断很重要、很必要,更要不断发展;二是确立护理诊断的指导思想,起源于医学,为医学分支,症状护理较符合医学逻辑;三是提高护理诊断用语的准确性、公认性;四是在中国建立护理诊断认可程序,完善后编入护理教材,为世界护理事业发展再添中国色彩。     

计算机辅助检测对检出乳腺X线片中成簇微钙化灶的价值

目的:探讨计算机辅助检测系统(CAD)对检出乳腺X线钼靶摄影片中成簇微钙化灶的临床应用价值。方法:将22例乳腺X线钼靶片上疑有簇状钙化灶患者和13例正常对照者的140张乳腺钼靶X线片,经专业扫描仪数字化处理后,应用CAD软件标记其中的微钙化灶,由6位放射科医师分别单独阅片,再结合CAD阅片,结果采用受试者操作特性(ROC)曲线法进行分析。结果:6位放射科医师结合CAD阅片后,评价效果均优于未结合CAD时,其中3位低年资医师(有1年临床经验)和1位中年资医师(有5年以上临床经验)的两次评价结果有显著性差异(P<0.05)。结论:CAD有助于提高乳腺X线片中成簇微钙化灶的检出率,尤其对缺少诊断经验医师的作用更大。     

The electro-oculogram in uveal melanoma

The electro-oculogram in 52 patients with a suspected malignant melanoma of the choroid or ciliary body was plotted in a diagram constructed for the differential diagnosis of malignant melanoma, metastasis, naevus and retinal detachment. Thirty-one patients were diagnosed as suffering from malignant melanoma on clinical grounds (19 histologically confirmed). Twenty-six were classified correctly as a melanoma using our EOG probability score. Rupture of Bruch's membrane and tumor localization were of no influence on the EOG classification. Accompanying retinal detachment lowered the Lp/Dt-ratio significantly without affecting the Dt, as was also the case in tumors with a prominence equal to or greater than 6mm when compared with smaller tumors. However melanomas were still classified correctly in the majority of the patients by means of EOG. We conclude that an acceptable differentiation can be made between melanomas, retinal detachments and naevi. Melanomas cannot be differentiated from choroidal metastases.     

X-刀治疗靶点定位精确度分析

目的 :研究SRS2 0 0X 刀治疗系统治疗靶点定位的精确度。方法 :应用人体头颅模型内特定标记物测定CT定位的精度 ,用胶片法测定二次等中心系统精度和总的治疗精度。结果 :BRW头环CT定位精度为 0 .65mm ,最大误差为 1 .0 9mm ;SRS2 0 0二次等中心系统误差为 0 .1 9mm ;总治疗误差理论计算值为0 .68mm ,胶片法检测值为 1 .43mm。结论 :X 刀治疗系统精确度已达到放射外科质量控制要求。     

Genetics: Genetic analysis prior to selective fetal reduction in multiple pregnancy: technical aspects and clinical outcome

Multiple pregnancies resulting from ovarian stimulation areat a higher risk of carrying at least one fetus affected byMendelian or chromosomal anomalies, the incidence of which isdirectly related to the order of multiples. Genetic analysisbefore fetal reduction was offered to both high-and low-riskpregnant women carrying two or more fetuses after ovulationinduction. Chorionic villus sampling (CVS) and fetal reductionwere achieved by transabdominal needling. The use of short-termculture, the polymerase chain reaction and fresh tissue enzymaticanalyses have made it possible for genetic diagnosis to be availablein a few days. A total of 100 patients had multifetal pregnancyreduction performed by a single operator; all of them completedpregnancy and none was lost at follow-up. The total fetal lossbefore 24 weeks was 7% and no statistically significant relationshipwas found with the final number of fetuses and CVS. Perinatallosses (3.9%) were only present in the series with a final numberof two fetuses. Pregnancy duration and birthweight were significantlyhigher in singletons than in twins, but were not related toCVS. The rate of chromosomal disorders was higher (7.2%) inthe study series than in singleton pregnancies not undergoingfetal reduction. Diagnostic error due to incorrect samplingwas reported in 1.5% of cases. These data support fetal reductionas a valuable strategy to improve the outcome of multiple pregnancy.The outcome of pregnancies reduced to singletons was significantlybetter than of those reduced to twins, and was not related toCVS. Therefore, prenatal genetic diagnosis should become anintegral part of counselling on multiple pregnancy, and is stronglyrecommended when reduction to singleton pregnancy is requested.     

血清LSA测定在恶性肿瘤临床诊断中的初步应用

本文根据Svennerholm和蒋谷人等的方法略加改良,测定了蚌埠地区113例正常人,71例恶性肿瘤患者和82例非肿瘤疾病患者血清脂质结合唾液酸(LSA)的含量。正常值为12.4mg/dl(SD=±3.6mg/dl),71例不同肿瘤患者的平均值为28.2mg/dl(SD=±9.7mg/dl),阳性率为88.7％,82例非肿瘤疾病患者的平均值为16.82mg/dl(SD=±5.4mg/dl),假阳性率为17％。方法的灵敏度,重复性(平均CV=3.6％)和回收率(平均回收率=101.4％)测定结果是满意的。本研究的初步结果表明,血清LSA测定对肺癌、白血病、胃癌和食管癌具有一定的临床诊断价值。     

原发性小肠肿瘤41例分析

本文报道我院1981年8月～1986年10月间收治的41例原发性小肠肿瘤,所有病例均经手术切除并经病理检查证实。本组男性24例,女性17例;年龄最小9个月,最大68岁。其中良性肿瘤5例,恶性肿瘤36例。肿瘤位于十二指肠者7例,空肠10例,回肠24例。 原发性小肠肿瘤的临床表现无一定规律,早期多无明显症状,且目前尚缺乏简便可靠的诊断措施,往往导致诊断延误。本文就本病的发生率,临床表现与诊断,误诊原因及辅助诊断等进行了讨论。