钼靶X线摄影与MRI检查对乳腺癌的诊断价值比较

目的:探讨钼靶X线与MRI对乳腺癌的诊断价值,以提高乳腺癌的检出率。方法:回顾性分析36例经手术病理证实的乳腺癌钼靶X线及MRI表现,并与病理结果对比分析。结果:钼靶X线诊断准确率为80.55%(29/36),MRI诊断准确率为88.88%(32/36);综合两者影像检查的诊断准确率为94.44%(34/36),明显优于单一钼靶X线摄影或MRI检查(P<0.05)。结论:钼靶X线摄影操作简单,对微小钙化敏感,为乳腺癌筛查的首选检查方法。MRI检查能显示乳腺内病变的细微结构,两者结合能显著提高乳腺癌的检出率和诊断准确率。     

高频彩超及X线钼靶诊断乳腺恶性肿瘤的价值比较及漏误诊原因分析

目的:比较高频彩超和X线钼靶对乳腺恶性肿瘤的诊断价值,并分析超声漏误诊原因.方法:对318例(328个病灶)经手术病理证实的乳腺恶性肿瘤患者术前超声及X线钼靶摄片结果与病理结果进行对照分析.结果:高频彩超及X线钼靶摄片诊断符合率分别为82.01%(269/328)、80.18%(263/328),两者间差异无显著性意义(P＞0.05);高频彩超与X线钼靶摄片联合的诊断符合率为92.99%(305/328),与单纯超声或钼靶摄片相比,差异均有显著性意义(P＜0.05).结论:高频彩超检查可作为乳腺恶性肿瘤诊断的首选方法之一,联合X线钼靶摄片可提高诊断符合率.     

钼靶、超声、核磁共振成像对隐匿型乳腺癌诊断价值的对比分析

目的:将钼靶、超声、核磁共振成像(MRI)在诊断隐匿性乳腺癌的诊断价值进行对比分析.方法:采用回顾性研究的方法,对术前患者进行钼靶X线、超声及MRI检查,以诊断准确率和钙化显示率为诊断标准,判别钼靶X线、超声及MRI三者对隐匿型乳腺癌诊断价值的差异.结果:MRI、超声和钼靶X线对隐匿型乳腺癌诊断准确率分别为91.43％(64/70)、82.86％(58/70)、72.86％(51/70),钙化显示率分别为为12.12％(8/70)、40％(28/70)、67.14％(47/70).三者之间的差异均有统计学意义(P＜0.05).结论:MRI时隐匿性乳腺癌的诊断价值优于超声和钼靶X线,钼靶X线对钙化较敏感.     

比较钼靶X线与高频超声对乳腺癌的诊断价值

目的 评价钼靶X线与高频超声对乳腺癌的诊断价值,以提高乳腺癌的检出率.方法 选择经手术病理证实的乳腺癌患者81例,对其X线、超声征象及其敏感性进行统计学分析.结果 (1)检出乳腺癌的敏感性分别为:钼靶X线82.7%(67/81),高频超声80.2%(65/81),两者比较差别无显著性;综合两者影像检查的敏感性为93.8%(76/81),明显优于单一钼靶X线或高频超声检查(P＜0.05).(2)钼靶X线与高频超声显示乳腺癌的征象有毛刺肿块、微细钙化、肿瘤血管及多种不典型征象.(3)钼靶X线对微细钙化检出率为54.3%(44/81),高频超声检出率为34.6%(28/81).钼靶X线检出钙化型乳腺癌比高频超声敏感(P＜0.05).(4)高频超声对乳腺癌血流信号检出率为81.5%(66/81),其中55.6%(45/81)见穿支血流;钼靶X线显示异常血管征为39.5%(32/81).高频超声检测血流信号明显优于钼靶X线(P＜0.01).结论 钼靶X线与高频超声作用互补,综合两种影像检查能显著提高乳腺癌的检出率.     

动态增强MRI联合钼靶X线对乳腺癌的诊断价值

目的分析乳腺癌的X线钼靶与MRI影像学表现,评价X线钼靶与MRI对乳腺癌的诊断价值。方法分析58例经手术病理证实的乳腺癌X线钼靶与MRI表现。MRI分别采用自旋回波T1WI、短时反转恢复（STIR）序列及动态增强扫描;X线钼靶采用常规方法摄片。结果MRI诊断正确53例,诊断准确率为91.37%,显示钙化8例,钙化显示率为13.97%;X线钼靶诊断正确42例,诊断准确率为72.41%,显示钙化38例,钙化显示率为65.52%。两者差异均有统计学意义（P〈0.01）。结论动态增强MRI对乳腺癌的诊断价值明显优于X线钼靶,钼靶对钙化显示较好,两者联合对乳腺癌的临床诊断具有重要意义。     

3.0T MR对隆乳后乳腺的诊断价值

目的:探讨3.0T MR对3种隆乳术后乳腺及其并发症的诊断价值?方法:对80例160只隆乳后乳房行MRI平扫及动态增强扫描,对假体及植入/注入物的MRI表现进行分析,影像学表现均与病理或临床进行对比?结果:①32例64只乳房行硅胶假体置入术,其中15只假体包膜皱缩;4只假体囊内破裂,其中1例伴浸润性导管癌;2只假体囊内外均破裂,其中1例伴感染;3只乳腺实质内见异常强化肿块,其中2例为纤维腺瘤,1例为浸润性导管癌;1例伴窦道形成;②42例84只乳房行聚丙烯酰胺水凝胶注射隆乳术,其中46只假体假包膜不完整,见假体游离;8只假体内见多发线样低信号分隔;4例双侧假体形态不对称,1例为假体移位,3例为假体假包膜破裂伴感染;1例假体取出后发现浸润性导管癌;1例合并浸润性导管癌;③5例10只乳房行自体脂肪移植术,4只移植脂肪坏死伴肉芽肿样反应; ④1例2只乳房行双重隆乳术?结论:3.0T MRI是评价隆乳术后情况的理想方法,T2-tirm及T2-FS序列可以准确显示植入/注入物的形态?层次,明确假体是否破裂及漏出物的分布范围,为临床手术提供准确定位,同时动态增强可以鉴别乳腺内肿块并及时发现乳腺实质内合并的其他良恶性病变?     

钼靶X线与高频超声对乳腺癌的诊断价值比较

目的:比较钼靶X线和高频超声对乳腺癌的诊断价值。方法:回顾分析经手术病理证实的85例乳腺癌患者的钼靶X线及高频超声资料。结果:钼靶X线与高频超声联合诊断乳腺癌阳性率(94.1%)明显优于单一方法(91.8%,90.6%)(P<0.05);乳腺癌钼靶X线征象为毛刺肿块、微细钙化、局限性致密、结构紊乱、大导管征、肿瘤血管、皮肤增厚、乳头凹陷;超声表现为不均匀低回声实性占位、细点状钙化、丰富血流;钼靶X线检出钙化型乳腺癌较超声敏感;高频超声检测血流信号明显优于钼靶X线。结论:钼靶X线与高频超声联合能显著提高乳腺癌的检出率和诊断率。     

MRI联合超声及钼靶X线对乳腺占位性病变的诊断价值

目的:分析磁共振成像(MRI)联合超声及钼靶X线对乳腺占位性病变的诊断价值。方法:选取2018年5月至2019年4月该院收治的96例疑似乳腺占位性病变的患者为研究对象,均行MRI、超声和钼靶X线检查,以病理诊断结果为“金标准”,统计MRI、超声、钼靶X线单项及联合检查的结果和诊断效能。结果:96例疑似乳腺占位性病变患者中,恶性病变79例,其中浸润性导管癌54例,腺样囊腺癌14例,髓样癌7例,浸润性小叶癌4例;良性病变17例,其中乳腺腺病10例,纤维腺瘤4例,乳腺增生2例,乳腺炎1例;MRI、超声、钼靶X线单项及联合检查诊断乳腺恶性病变的特异度和误诊率比较,差异均无统计学意义(P>0.05);钼靶X线和超声检查诊断乳腺恶性病变的灵敏度、准确度、漏诊率比较,差异均无统计学意义(P>0.05);联合检查与MRI检查诊断乳腺恶性病变的灵敏度、准确度、漏诊率比较,差异均无统计学意义(P>0.05);MRI、联合检查诊断乳腺恶性病变的灵敏度、准确度、漏诊率均高于钼靶X线、超声单项检查,差异有统计学意义(P<0.05)。结论:MRI联合超声及钼靶X线诊断乳腺占位性病变可提高灵敏度、准确度,降低漏诊率,具有较高的诊断价值。     

高频超声与钼靶X线相结合诊断乳腺肿瘤的应用价值

目的:探讨高频超声与钼靶X线相结合诊断乳腺肿瘤的诊断价值。方法:回顾性分析2008年8月至2010年8月我院200例乳腺肿瘤患者的高频超声和钼靶X线影像表现,将两者联合诊断的结果与术后病理诊断结果对照。结果:超声检查诊断准确率为82.5%,钼靶X检查诊断准确率为78.3%,高频超声与钼钯X线相结合检查诊断准确率为91.6%,高频超声对良性肿块的诊断准确率优于钼靶X线,而钼靶X线对乳腺恶性肿块尤其是钙化的显示优于高频超声。结论:高频超声与钼靶X线相结合可明显提高乳腺肿瘤诊断的准确率,是临床诊断乳腺肿瘤的重要方法。     

硅凝胶隆乳假体及术后并发症的MRI表现分析

目的分析硅凝胶隆乳及隆乳术后并发症的MRI表现,探讨其临床价值。资料与方法收集20例经MRI检查的隆乳术后患者,分析不同隆乳假体及并发症的MRI表现。结果硅凝胶假体20例40个乳腺,正常硅凝胶假体10例20个,硅胶囊假体破裂10例14个,其中8例属囊内破裂,2例属囊外破裂,MRI可清楚显示其包膜及内部结构。结论 MRI检查可明确硅凝胶假体的位置、类型,观察隆乳术后各种并发症的发生,有助于临床诊断和治疗。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.