乳腺肿块样改变的彩超诊断价值(附76例分析)

目的：回顾性分析了76例乳腺肿块二维声像图和彩色多普勒血流表现，探讨乳腺肿块的诊断和鉴别诊断。方法：76例乳腺肿块经二维超声了解其形态，边界，边缘、内部回声，有无后方衰减及侧方声影等，然后用彩色多普勒检查，观察肿块内部及周边血流情况，结果：在乳腺肿块声像图诊断中，以边界回声特征最为重要，它是鉴别良，恶性肿块的关键，本组大多数恶性肿块形态不规则，边界不清，内部回声较低且不均匀，同时彩色多普勒检查出丰富或散在血液信号，良性肿瘤多表现边界光滑，内回声均匀，彩色多普勒检查大多数无明显的血流信号，结论：二维及彩色多普勒诊断乳腺肿块等符合率较高，且具较大的临床应用价值。     

彩色超声在浅表淋巴结病变良恶性鉴别诊断中的应用

目的:探索高频彩超对肿大淋巴结节良恶性的鉴别诊断。方法:本文回顾分析了45例(157个)肿大浅表淋巴结的超声检查。结果:良性23例(93个),恶性22例(64个)。均经穿刺和(或)手术活检病理证实。结论:良恶性淋巴结的2D表现和皮质、髓质、门部的改变及L/S比值具有各自的特性,结合CDFI的血管分布形态和PW中的Vmax和RI有助于进一步区分良恶性。     

彩超对乳腺肿块诊断临床价值

目的：探讨高频彩色多谱勒血流显像（CDFI）超声对乳腺肿块诊断的临床应用价值。方法：对432例乳腺肿块进行高频彩色多谱勒血流显像（CDFI）超声检查。本文对432例乳腺肿块经高频CDFI检查诊断,并经手术及病理证实的乳腺肿块进行回顾性分析。结果：高频CDFI诊断432例肿块中,实质性410例,囊性22例,良性肿块231例,恶性肿块201例。对肿块的囊性、实质性、混合性的检出率100%。良恶性肿块除18例与手术病理不符合外,总符合率为95.8%（414/432）。高频CDFI超声对乳腺彩色血流的检出率为70.3%（304/432）。良恶性肿块的动脉血流阻力指数有显著差异,P〈0.01.[1]结论：高频CDFI超声检查对乳腺肿块的性质、良恶性鉴别诊断,对临床手术均有指导意义,此检查方法就作为乳腺肿块诊断的首选方法之一。     

超声对桥本甲状腺炎良恶结节的鉴别诊断价值

目的 探讨分析超声对桥本甲状腺炎良恶结节的鉴别诊断价值。方法 选取88例桥本甲状腺炎患者经超声检查合并甲状腺结节,再进行穿刺病理检查,分析超声检查桥本甲状腺炎良恶结节特征,超声与病理诊断对比分析。结果 超声检查显示的桥本甲状腺炎良、恶性结节患者结节的形态、边界、内部回声、钙化、声晕、结节个数差异均具有统计学意义(P<0.05),但良恶性结节患者的结节血流情况,差异无统计学意义(P>0.05);超声诊断桥本甲状腺炎良恶性结节的灵敏度为82.14%、特异度96.67%,与病理诊断的符合率为92.05%。结论 超声诊断桥本甲状腺炎良恶结节准确率较高,值得进一步在临床上推广。     

彩色多普勒超声对异位妊娠破裂的诊断及鉴别诊断

目的讨论实时彩色多普勒超声对异位妊娠破裂的诊断及鉴别诊断。方法采用PHILIPSEnVisorC彩色多普勒超声诊断仪对15例疑似异位妊娠破裂患者的声像图进行分析与鉴别诊断。结果15例妇产科疑似异位妊娠破裂患者,手术后经病理科证实12例为异位妊娠破裂,3例误诊。结论实时超声对异位妊娠破裂有很高的诊断和鉴别诊断价值。     

探讨经腹部及经阴道彩色多普勒超声在异位妊娠诊断中的临床价值

目的探讨经腹部及经阴道彩色多普勒超声在异位妊娠诊断中的临床价值。方法经腹部及经阴道彩色多普勒超声检查160例异位妊娠患者。结果 160例宫外孕,经手术证实输卵管妊娠129例,宫颈妊娠8例,卵巢妊娠8例,均与超声诊断相符。5例超声诊断为腹腔妊娠,其中4例手术证实为卵巢妊娠,4例超声诊断为残角子宫妊娠,3例手术证实为输卵管间质部妊娠,子宫肌壁间妊娠1例,5例超声初次检查为阴性,再次复查诊断为异位妊娠,超声诊断符合率90.6%。结论经腹及经阴道彩色多普勒超声图像直观、方便、安全,可以多次复查而无创伤性,联合运用为超声诊断异位妊娠提供更多重要的参考信息。     

微光成像实验平台的光路设计

将多像素光子计数器(Multi-pixel Photon Counter, MPPC)应用于三维成像,MPPC与光学成像结构相结合,对微光成像实验平台进行了光路设计。该设计将平面探测改为实物立体探测,同时实现极低照度下的目标成像。设计了一个焦距范围为30～85 mm,视场大于20°,场曲小于2%的光学成像结构,并通过光学设计软件对光学结构进行优化,使其满足设计指标。搭建了二维微光成像系统进行实物物体探测。通过实验验证,该系统可以实现10~(-4) lx以及更低照度的微光环境下,40 cm距离的目标物体的二维成像。     

基于灰度密度分布特征的肺结节良恶性分类

CT 图像中肺结节良恶性鉴别是肺癌计算机辅助诊断研究中的关键。为了提高计算机辅助诊断系统中肺结节良恶性诊断准确性,提出一种基于密度分布特征的肺结节良/恶性判断方法。首先,从肺部肿瘤图像中随机提取图像小单元集并计算其自相关矩阵,然后通过K-means算法对该矩阵实现无监督聚类。特征提取时遍历计算肺结节图像每一像素的灰度密度分布等级,并统计、归一化得到10维特征向量,最后通过卷积方法对特征进行优化。同时,利用随机森林分类器进行模型训练,进而判断肺结节良/恶性水平,提出算法的验证数据为LIDC-IDRI。实验结果表明,最大AUC可达0.955 8。对比分析,该特征表达方法具有更优分类效果和更高鲁棒性。     

冠心病患者颈动脉粥样硬化与血管内皮舒张功能的临床研究

目的：研究冠心病患者颈动脉粥样硬化与血管内皮舒张功能的临床意义。方法：采用高频超声测量冠心病组和对照组颈动脉斑块积分、斑块数、颈动脉内-中膜厚度（IMT）及血管内皮舒张功能（EDD％），并进行对比分析。结果：1．冠心病组颈动脉IMT、斑块积分及斑块数明显高于对照组，多支冠脉血管病变组明显高于单支病变组；2．冠心病组内皮舒张功能明显低于对照组，单支、双支病变组间无显著性差异。3．冠状动脉造影与颈动脉超声结果比较，以斑块存在为预测冠脉病变的阳性指标，敏感性为83％、特异性75％。结论：冠心病患者多合并血管舒张功能受损及颈动脉粥样硬化，高频超声探查颈动脉可预测冠状动脉病变的存在及严重程度。     

计算机扫描血管造影(CTA)对脑血管疾病诊断的系统评价

目的:评价计算机断层扫描血管造影(Computed tomographic angiography,CTA)是否可能取代脑血管造影(d igital subt raction angiography,DSA)对脑血管的评估及对脑血管疾病的诊断。方法:检索电子数据库,并从相关文章的参考文献中查找可能符合纳入标准的文献。在纳入的研究中包括CTA及DSA对成年人与怀疑/已知的脑血管疾病报告中的敏感性和特异性,或真、假阳性以及阴性。所有数据使用MetaD isc软件进行Meta分析。结果:9个研究的合并敏感度为89.6%;合并特异度为93.4%;合并阳性似然比+LR=9.038;合并阴性似然比-LR=0.086;SROCAUC0.9682,SE 0.0197。结论:CTA对脑血管疾病诊断具有高度敏感性,且具有较高的阴性预测值,可作为脑血管病的筛查手段。     

Serum protein fingerprinting coupled with artificial neural network distinguishes glioma from healthy population or brain benign tumor

To screen and evaluate protein biomarkers for the detection of gliomas (Astrocytoma grade Ⅰ-Ⅳ) from healthy individuals and gliomas from brain benign tumors by using surface enhanced laser desorption/ionization time of flight mass spectrometry (SELDI-TOF-MS) coupled with an artificial neural network (ANN) algorithm. SELDI-TOF-MS protein fingerprinting of serum from 105 brain tumor patients and healthy individuals, included 28 patients with glioma (Astrocytoma Ⅰ-Ⅳ), 37 patients with brain benign tumor, and 40 age-matched healthy individuals. Two thirds of the total samples of every compared pair as training set were used to set up discriminating patterns, and one third of total samples of every compared pair as test set were used to cross-validate; simultaneously, discriminate-cluster analysis derived SPSS 10.0 software was used to compare Astrocytoma grade Ⅰ-Ⅱ with grade Ⅲ-Ⅳ ones. An accuracy of 95.7%, sensitivity of 88.9%, specificity of 100%, positive predictive value of 90% and negative predictive value of 100% were obtained in a blinded test set comparing gliomas patients with healthy individuals; an accuracy of 86.4%, sensitivity of 88.9%, specificity of 84.6%, positive predictive value of 90% and negative predictive value of 85.7% were obtained when patient's gliomas was compared with benign brain tumor. Total accuracy of 85.7%, accuracy of grade Ⅰ-Ⅱ Astrocytoma was 86.7%, accuracy ofⅢ-Ⅳ Astrocytoma was 84.6% were obtained when grade Ⅰ-Ⅱ Astrocytoma was compared with grade Ⅲ-Ⅳ ones (discriminant analysis). SELDI-TOF-MS combined with bioinformatics tools, could greatly facilitate the discovery of better biomarkers. The high sensitivity and specificity achieved by the use of selected biomarkers showed great potential application for the discrimination of gliomas patients from healthy individuals and glioma from brain benign tumors.     

Ultra-Cut biopsy guided by ultrasonography for liver lesions: experience of 392 clinical cases

We conducted a retrospective study of the accuracy of liver biopsies in 392 patients with liver lesions. Postbiopsy diagnosis was 297 cases of primary liver cancers, 79 cases of secondary malignant tumors, 2 cases of non-Hodgkin's lymphoma, 10 cases of focal nodular hyperplasia, 2 cases of chronic inflammation, 1 tuberculosis case and 1 schistosomiasis case. Biopsy provided histological diagnosis in 100% of cases, sensibility and specificity of Ultra-Cut biopsy was 98.95% and 100% for the diagnosis of malignancy respectively; positive predictive value, 100%; negative predictive value, 71.43%; and accuracy, 98.98%. We identified no major procedure related complications despite the presence of thrombocytopenia in 37.5% of cases. Pain was the only reported adverse effect of liver biopsy (10.97%), and 11 patients required analgesics. We concluded that Ultra-Cut liver biopsy was a safe and effective technique, and was invaluable in the investigation and management of patients with liver lesions.     

胎儿纤维连接蛋白联合宫颈长度在早产预测中的价值

目的探讨胎儿纤维连接蛋白（fFN）联合宫颈长度检测预测早产的价值。方法采用ELISA法检测86例先兆早产孕妇宫颈阴道分泌物中胎儿fFN水平,阴道B超测量其宫颈长度,分析其预测妊娠结局的价值。结果胎儿fFN测定联合宫颈长度预测早产的敏感性、特异性、阳性预测值和阴性预测值分别为97.30%、75.00%、87.80%和100.00%,其特异性、阳性预测值明显高于胎儿fFN及宫颈长度单独检测（P〈0.05）。结论胎儿fFN检测联合宫颈长度对预测早产有较高的价值。     

雌孕激素受体与P53、bcl-2基因蛋白在大肠良恶性病变中表达的相关性研究

目的探讨ER、PR、P53、bcl-2在大肠良恶性病变中的表达相关性.方法利用ER、PR、P53及bcl-2特异性抗体对75例大肠良恶性肿瘤进行SABC免疫组织化学染色.结果四种抗体联合表达率在47例大肠恶性肿瘤、28例良性增生性疾病和41例癌旁移行区粘膜分别为26.83%、10.7%和0.10例大肠息肉P53和bcl-2均无表达,41例癌旁移行区未见P53表达.ER、PR联合表达率在大肠癌(42.55%)明显高于癌旁(17.07%),P53和bcl-2联合表达率在癌、良性增生和癌旁分别为48.94%、17.80%和0,三者间差异显著.而四种抗体表达与患者性别、年龄无关.结论ER、PR、P53和bcl-2表达与大肠肿瘤发生有关.P53基因突变是人类大肠癌发生的最常见的遗传学改变之一,bcl-2是大肠癌发生的早期分子水平标志;激素及其受体改变促进肿瘤的发生并且雌、孕激素受体水平与肿瘤的病理分化程度有关.     

中职生主观幸福感与自尊、情绪的相关研究

以420名中职生为研究对象,考察其主观幸福感,以及与主观幸福感相关的因素。运用回归分析等统计处理数据。研究结果表明：（1）自尊与主观幸福感呈正相关,并有预测作用;（2）积极情绪与主观幸福感各因子有正相关,并有正向预测作用。消极情绪与主观幸福感有负相关,并有负向预测作用。     

Diagnostic value of computed tomography (CT) histogram analysis in thyroid benign solitary coarse calcification nodules

This study was to investigate the diagnostic value of the computed tomography (CT) histogram in thyroid benign solitary coarse calcification nodules (BSCNs). A total of 89 thyroid solitary coarse calcification nodules (coarse calcification ≥5 mm, no definite soft tissue around calcification) confirmed either by surgery or histopathological examination in 86 cases enrolled from January 2009 to December 2015 were evaluated. These included 56 BSCNs and 33 malignant solitary coarse calcification nodules (MSCNs). Overall, 27 cut-off values were calculated by N (4≤N≤30) times of 50 Hounsfield units (HU) in the range of 200 to 1500 HU, and each cut-off value and the differences in the corresponding area percentages in the CT histogram were recorded for BSCN and MSCN. The optimal cut-off value and the corresponding area percentage were established by receiver operating characteristic (ROC) curve analysis. In the 19 groups with an ROC area under curve (AUC) of more than 0.7, at a cut-off value of 800 HU and at an area percentage of no more than 93.8%, the ROC AUC reached the maximum of 0.79, and the accuracy, sensitivity, and specificity were 75.3%, 80.4%, and 66.7%, respectively. At a cut-off value of 1050 HU and at an area percentage of no more than 93.6%, the accuracy, sensitivity, and specificity were 71.9%, 60.7%, and 90.9%, respectively. At a cut-off of 1150 HU and area of no more than 98.4%, the accuracy, sensitivity, and specificity were 70.8%, 57.1%, and 93.9%, respectively. At a cut-off of 600 HU and area of no more than 12.1%, the accuracy, sensitivity, and specificity were 61.8%, 39.3%, and 100.0%, respectively. Compared with the cut-off value of 800 HU and an area percentage of no more than 93.8%, the sensitivity of cut-off values and minimum areas of 1050 HU and 93.6%, of 1150 HU and 98.4%, and of 600 HU and 12.1%, was gradually decreasing; however, their specificity was gradually increasing. This can provide an important basis for reducing the misdiagnosis and unnecessary surgical trauma.     

留守初中生适应特点及其与心理弹性的关系

尝试探讨留守儿童积极适应、消极适应的特点及其与心理弹性的关系.采用社会适应问卷和心理弹性量表对232名农村留守初中生积极适应、消极适应和心理弹性进行测查.结果显示：留守初中生的积极适应和消极适应各指标得分均呈偏态分布;不同适应类型留守儿童的心理弹性得分存在显著差异,高危型学生弹性水平最低,适应型学生弹性水平最高;心理弹性对积极适应和消极适应具有显著预测作用,累积解释力分别达到61％和37％.其中,目标专注对积极适应的预测力最大,情绪控制对消极适应的预测作用最大;积极认知有助于提升积极适应功能,家庭支持则有助于减少消极适应症状.结果表明：心理弹性对留守儿童适应的预测作用具有领域特异性.     

（3＋1）维KP方程的Wronskian解

本文通过构造Wronskian行列式,并利用行列式的性质通过复杂的计算证明该Wronskian行列式满足给出的双线性导数方程,进一步给出孤子方程的Wronskian解。     

The utility of kindergarten teacher ratings for predicting low academic achievement in first grade

The purpose of this study was to assess the predictive value of kindergarten teachers' ratings of pupils for later first-grade academic achievement. Kindergarten students were rated by their teachers on a variety of variables, including math and reading performance, teacher concerns, and amount of learning relative to peers. These variables were then analyzed with respect to outcome measures for math and reading ability administered in the first grade. The teachers' ratings of academic performance were significantly correlated with scores on the outcome measures. Analyses were also carried out to determine sensitivity, specificity, and predictive values of the different teacher ratings. The results indicated high overall accuracy, sensitivity, specificity, and negative predictive value for the ratings. Positive predictive value tended to be lower. A recommendation to follow from these results is that teacher ratings of this sort be used to determine which children should receive cognitive screening measures to further enhance identification of children at risk for learning disability. However, this recommendation is limited by the lack of empirically supported screening measures for math disability versus well-supported screening tools for reading disability.     

评估普通人群肝脂肪变性磁共振成像定量方法的可行性

为了探讨采用3T西门子MRI LiverLab评估普通人群志愿者肝脏脂肪含量的可行性,招募了60名志愿者,其中双回波Dixon技术预测肝脂肪变性的患病率为51.7％(31/60),多回波Dixon和多回波HISTO技术测量的平均肝脏质子密度脂肪分数分别为(9.1±1.9)％和(9.3±2.3)％,测量结果在统计学上没有...