目的:研究并探讨腹部磁共振弥散加权成像(Diffusion weighted imaging,DWI)技术在肝脏良、恶性肿瘤鉴别诊断中的应用价值.方法:选择2015年1月1日—2017年12月31日就诊于我院的75例肝脏肿瘤患者,对其进行常规MRI、DWI检查,以手术病理诊断结果 为参照,计算和比较常规MRI、DWI的鉴别诊断灵敏度、特异度、准确性.根据手术病理诊断结果,将患者分为良性病变组、恶性病变组,比较两组在不同b值下的表观弥散系数(Apparent diffusion coefficient,ADC).结果:DWI的鉴别诊断灵敏度、特异度、准确率均高于常规MRI(P<0.05).在不同b值下,恶性病变组的ADC值均低于良性病变组(P<0.05).结论:在肝脏良恶性肿瘤鉴别诊断时,应用磁共振DWI技术可对肝脏良性肿瘤与肝脏恶性肿瘤予以准确鉴别区分,其定性诊断价值显著.

目的：探讨磁共振在子宫内膜癌分期的应用价值。方法2013年6月至2015年8月期间，本院市两所三级医院共收治了60例子宫内膜癌患者，所有的患者在手术前都实施MRI检查，然后再进行手术治疗，对术前MRI分期与手术病理分期结果进行评估。结果磁共振诊断Ⅰa期、Ⅰb期、Ⅱ期、Ⅲ期、Ⅳ期子宫内膜癌诊断敏感度分别为94.12%、83.33%、83.33%、80%、66.67%，准确度分别为96.97%、76.92%、83.33%、80%、66.67%。结论在早期子宫内膜癌术前分期中，磁共振诊断的准确率较高，值得临床应用。

目的:探究盆腔磁共振T2加权像在老年前列腺癌中的诊断价值.方法:选取我市两所医院在2013年5月-2015年6月期间收治的170例前列腺疾病患者,所有患者均实行前列腺穿刺活检以及盆腔磁共振T2加权成像,对其影像学以及前列腺癌临床诊断相关因素进行分析.结果:170例患者经过活检穿刺之后证实70例患者为前列腺癌,同时年龄、PSA、病灶数目以及形态和前列腺癌之间具有直接的关系,通过比较,P＜0.05,具有统计学意义.结论:对老年前列腺癌患者采用盆腔磁共振T2加权像进行诊断具备重要的临床意义.

Objective To survey the incidence of nutritional risk and undernutrition and the status of nutritional support on surgical inpatients in general surgery departments of 5 middle and small hospitals in Jilin province.Methods A total of 4 330 hospitalized patients from the surgical departments of 5 hospitals in Changchun,Songyu,and Baicheng of Jilin province were recruited from May2010 to March 2013.Among them 687 cases entered the final analysis based on the exclusion criteria.They were further divided as group Ⅰ (n =140,including patients with gastric cancer or colorectal cancer) and group Ⅱ (n =547,including patients with gastric ulcer,intestinal obstruction,or Crohn's disease).Nutritional Risk Screening 2002 was performed within 24 hours after admission.The incidence of undernutrition and nutrition risk was calculated,and the nutritional support was evaluated until the discharge.Results In these two groups,167 patients (24.3％) were at nutritional risk,among whom 73.7％ received nutritional support and 26.3％ received non-nutritional support.Also,520 cases were not at nutritional risk,among whom 8.8％ received nutritional support and 91.2％ received non-nutritional support.In addition,64.3％ of patients were at nutritional risk in group Ⅰ and 14.1％ in group Ⅱ (P =0.000).Among these 687 cases,body mass index was ＜ 18.5 kg/m2 in 3.2％ of patients and nutritional status ≥3 scores in 8.3 ％ (P =0.000).Conclusions Patients with different gastrointestinal diseases may have different nutritional risks and undernutrition status.Parenteral nutrition support has been applied in 5 middle and small hospitals in Jilin provinicne,while enteral nutrition and combination of parenteral nutrition and enteral nutrition has not been introduced.

Objective To observe the clinical effects of Xiyanping injection on pneumonia caused by Hand -foot-mouth disease(HFMD).Method TO review 158 HFMD patients with pneumonia;There are 100 cases injected Xiyanping and 58 cases not injected.Compare the former with the latter on the time of fever,deflorescence, white blood cells,myocardial enzyme and Pulmonary shadow fading,and the number of severe cases.Result There was a significant difference in fever length(days),Bleb subsidizing length(days),white cells keep in normal days,Pulmonary shadow fading days,and the incidence of severe cases between the treatment group and control group.Conclusion Xiyanping injection is exactly safe and reliable for curing pneumonia ,and can shorten the length of stay and reduce the incidence of severe pneumoni-a.

《营养》(Nutrition) 2010年第26卷11 ～12期发表了揭彬等撰写的《营养支持对有营养风险患者临床结局的影响》一文.营养支持是否能改善患者的临床结局?研究表明肠外营养(parenteral nutrition,PN)可降低严重营养不良患者非感染性并发症的发生率;营养不良患者肠内营养(enteral nutrition,EN)与降低感染性并发症发生率以及缩短住院时间(length of hospital stay,LOS)有关,而营养良好患者则不然.然而,营养良好患者也可因疾病或住院期间治疗营养摄取减少,体重减轻,并因此发生营养不良.

Objective To investigate the features of postoperative complication and length of hospital stay caused by nutritional risk on surgical inpatients with gastrointestinal diseases in general surgery department of 5 middle and small hospitals in Jilin province.Observe the impact of parenteral nutrition on clinical outcome in the surgical patients with gastrointestinal diseases. Methods In the cohort study, a total of 4349 hospitalized patients from 5 hospitals of relatively developed Changchun area, Songyu area, and Baicheng area in general surgery department of Jilin province were recruited from May 2010 to March 2013. After the patients were excluded for hospital lengh of age less than 18 years old or more than 80 years old, stay less than 24 hours or operation before the next day 8 o'clock, obnubiation and /or refuse to participate in the research, and inconformity to scheduled diagnosis, 405 cases were sampled. Collected research material mainly included nutrition risk screening, the status of application on enteral and paraenteral nutritional support, operation, complications and length of hospital stay. Results A total of 405 cases met the inclusion criteria were recruited from these areas. There are 235 cases at non- nutritional-risk, and there are 26 at complications.The incidence of complication was 4.9% in at-nutritional risk patients recieved enteral nutritional support and 14.7% in at-nutritional risk patients non-enteral nutritional support. Conclusion Nutrition support can decrease compliactions of at-nutritional-risk patients and length of hospital stay, but non-nutritional-risk patients is not so。

1 营养风险和疾病相关性营养不良的发病率上世纪70年代发表的几项研究首次指出了“疾病相关性营养不良”( disease-related malnutrition,DRM)这个从未被关注的临床问题.此后有很多基于不同患者群体、不同基础疾病及不同年龄组成的营养不良发病率的调查研究相继发表.总体来看,营养风险和DRM的已发表研究涉及呼吸内科、心脏内科、普外科、骨科、神经内科、老年精神科、肿瘤科及儿科等多个科室.许多对患者住院全过程进行随访观察的研究已经证实,入院时即存在营养不良的患者在住院期间存在较高的营养状况恶化的风险.利用人体测量标准,在英国已发现恶性疾病、慢性非恶性疾病和手术出院后的DRM发病率约为10％.不同患者群体的门诊预约中也记录了不同的营养不良发生率.在美国利用不同测量标准对敬老院老年人进行的研究发现营养不足的发生率在10％ ～ 85％之间。