目的 探讨肝癌经导管肝动脉化疗栓塞(TACE)手术后双源CT灌注成像检查评价治疗效果.方法 选取50例肝癌患者临床资料,均行TACE手术治疗.分别在手术前3天、手术后1周及手术后1个月时对其开展双源CT灌注成像复查.分析TACE手术前后病灶双源CT灌注成像情况;对比TACE手术前后碘油填充致密区和稀疏区各项灌注参数情况;对比TACE手术后1周及手术后1个月时碘油稀疏区各项灌注参数情况;满意度情况.结果 所有病患在手术前后均开展双源CT灌注成像检查.手术前50个病灶在肝动脉灌注量图像上呈现高肝动脉灌注;手术后有23个病灶碘油填充致密,被碘油完全栓塞;27个病灶碘油栓塞不均匀,碘油致密区域门静脉灌注量图和肝动脉灌注量图均无血流灌注,碘油稀疏区域表示为高肝动脉灌注.TACE手术后碘油稀疏区、手术后碘油栓塞区肝动脉灌注量以及肝动脉灌注指数均低于手术前原发病灶,手术后碘油栓塞区门静脉灌注量高于手术前原发病灶(P＜0.05).手术后1个月碘油稀疏区肝动脉灌注量以及肝动脉灌注指数均高于手术后1周(P＜0.05).总满意度为94.00％.结论 肝癌病患TACE手术后开展双源CT灌注成像检查,能够有效判断治疗效果,对手术后残余病灶监测可发挥积极作用,而开展护理干预还可提升满意度,发挥一定干预作用.

目的：探讨体外循环（CPB）辅助技术在腔静脉肿瘤手术治疗中的应用及效果。方法回顾性分析8例腔静脉肿瘤在 CPB 辅助下行手术治疗的相关资料，其中3例为原发或继发下腔静脉平滑肌瘤（其中1例蔓延至右心房），1例为原发性平滑肌肉瘤，1例为肝癌下腔静脉内转移，2例为肾癌下腔静脉转移，1例为胸腺瘤累及上腔静脉及右心房。通过右房原主动脉插管或右心房回输管建立 CPB 行辅助循环。结果8例患者均成功将腔静脉肿瘤完整切除，顺利出院。术后随访显示，1例术后2个月出现肝衰竭死亡，2例分别于术后4、6个月复发再次手术，其余5例随访1 a 无复发。结论 CPB 辅助技术在腔静脉肿瘤手术治疗中的应用，扩大了手术适应证，有效维持血流动力学稳定，同时通过充分暴露术野，保证了肿瘤的彻底切除。

Objective:To study the effect of ultrasound in the diagnosis of thyroid tumor. Method:To collect 150 cases of thyroid tumor patients,from October 2012 to September,using color doppler ultrasound instrument in diagnosis.Results:In the 150 cases of thyroid tumor patients,135 cases ultrasound diagnosis is consistent with the pathological diagnosis,diagnosis coincidence rate is 90.0%.In 18 cases of thyroid cancer,ultrasound diagnosis 9 cases,correct diagnostic rate is 75.0%.Thyroid cancer patients resistance index 0.65±0.21,end diastolic velocity 7.4 ± 2.6EDcm/s,peak systolic velocity 18.5±4.6PScm/s.Thyroid adenoma patiens resistance index 0.59 ± 0.18,end diastolic velocity 6.9±2.3EDcm/s,peak systolic velocity 12.5 ± 3.8PScm/s.Resistance index and peak systolicvelocity in both groups have significant difference(P<0.05),end diastolic velocity was no significant difference(P>0.05).Conclusion:The shape of tumors,internal echo,interior peak systolic velocity(PS),Resistance index(RI) are important indexs to distinguish thyroid tumors and thyroid cancer.

以往的观点往往认为年龄较大的患者,由于延误治疗而导致同侧有胸腔积液的患者已属晚期,失去手术机会.

Objective To study the difference of the microvessel density(MVD) in three types of breast diseases and analyze the relationship between them with the expression of TSP-1,CD44V5,HER4 genes.Methods Using immunohistochemistry(IHC) SP staining technique,TSP-1,CD44V5,HER4 protein and MVD were detected in the lesion of three types of diseases,including breast fibroadenoma,breast lobular hyperplasia and breast invasive ductal carcinoma(IDC).Results MVD of IDC is higher than that of the others(P0.05);the MVD of all these diseases showed no relationship with the expression of TSP-1 and CD44V5(P0.05),but showed significance in the relationship with HER4,the MVD with HER4 positive is higher(P0.05).Conclusion MVD of IDC is higher than that of the benign diseases;HER4 may prompt the generation of microvessel.

Aim: To investigate the difference of thrombospondin-1(TSP-1) expression and microvessel density (MVD) in breast invasive ductal carcinoma (IDC) between Uigur and Han people. Methods: TSP-1 protein and MVD were detected using immunohistochemistry in 70 IDC cases of Han nationality and 70 IDC cases of Uigur people. Results: TSP-1 expression and MVD had no difference between the 2 people (P0.05). Conclusion: The genesis and regulation of microvessel may be not related to the race background in Uigur and Han people with IDC lesions.

贲门癌术后吻合口瘘始终是导致患者围术期病死率较高的一种严重并发症.如何有效减少术后吻合口瘘,经过复习文献,结合我们的经验,对153例高龄贲门癌行机械切除后采用机械吻合及生物蛋白胶涂抹加固的方法预防吻合口瘘的发生,取得满意的效果.

Objective To study the expression of TSP-1,CD44v5,erbB4 genes in three types of breast diseases and analyze the relationship between each other.Method Using immunohistochemistry(IHC) staining technique,TSP-1,CD44V5,erbB4 proteins in the lesion of sixty cases of three types of diseases,including breast fibroadenoma,breast lobular hyperplasia and breast invasive ductal carcinoma(IDC) were detected.Result The positive rate of erbB4 in IDC is higher than that of the others(P0.05).The expression of the other two showed no relationship with the type of lesion(P0.05).The expression of erbB4 and TSP-1 showed positive correlation(r=0.404,P0.05),but there were no correlation found among the others(P0.05).Conclusion erbB4 may prompt the carcinogenesis of IDC.The expression of erbB4 and TSP-1 has positive correlation.