目的 探讨乳腺癌剪切波弹性成像(SWE)最大硬度值(Emax)与其临床病理因素的关系.方法 术前对76例乳腺癌病灶进行灰阶超声检查,单因素和多元线性回归方法分析Emax与乳腺癌临床病理因素的关系.结果 单因素分析结果显示,Emax与病灶大小、病理分级及腋窝淋巴结转移情况有关,差异有统计学意义(P＜0.05);多元线性回归分析结果显示,Emax仅与病灶大小及腋窝淋巴结转移情况有关,差异有统计学意义(P＜0.05).结论 SWE定量参数Emax与乳腺病灶大小、腋窝淋巴结的转移情况有一定关系,可能对乳腺癌的预后评估有一定价值.

Traditional Chinese Medicine (TCM) therapies should be tailored according to the different syndrome types. In order to identify the relationship between the TCM Yin-cold (YC) or Yang-heat (YH) syndrome types and the EGFR gene status, we prospectively studied 310 NSCLC patients. TCM YH or YC was diagnosed by three TCM experts. TCM symptoms and signs were entered into a binary cluster analysis. The relationships between the EGFR gene status, YH or YC syndrome types, and classification by cluster analysis were analyzed using the chi-square test and multivariate logistic regression. In the 299 patients who had their EGFR gene tested, 45.24% YC (76/168) and 25.95% YH (34/131) patients had EGFR mutations (p = 0.001). Among the 292 patients entered into the cluster analysis, 132 were classified into group A, with signs and symptoms similar to YC, whereas 160 group B patients were similar to YH. In the 281 patients with EGFR tested, 45.67% group A (58/127) and 28.57% group B patients (44/154) had EGFR mutations (p = 0.003). The EGFR status was independently correlated with TCM syndrome type and classification by cluster analysis on multivariate logistic regression. NSCLC patients with YC were more likely to have EGFR gene mutations.

[目的]分析总结不同部位胃肠道淋巴瘤的多层螺旋CT表现及鉴别诊断.[方法]回顾性分析135例经手术病理证实的胃肠道淋巴瘤患者,就胃肠道淋巴瘤的发生部位、病理类型及多层螺旋CT表现进行分析和讨论.所有病例均采用GE lightspeed 16或Siemens Somatom Definition 64层双源螺旋CT扫描.[结果]胃淋巴瘤发生率最高(69例),其次为小肠淋巴瘤(40例).最常见的病理类型是弥漫大B淋巴瘤(87例)及MALT淋巴瘤(24例).大多数胃淋巴瘤(60例)表现为胃壁增厚,但未见明显梗阻征象,增强扫描14例可见黏膜白线征.动脉瘤样扩张(9例)、病灶内积气(3例)及“夹心面包征”(2例)则是小肠淋巴瘤的特征性表现.结直肠淋巴瘤少见(26例),CT表现与小肠淋巴瘤相似.[结论]胃肠道淋巴瘤的MSCT表现具有一定特异性,特别是回肠淋巴瘤,有助于胃肠道淋巴瘤的诊断及鉴别诊断.

目的 探讨青年与中老年乳腺癌患者的临床病理及超声表现.方法 对经手术病理证实的288例乳腺癌患者进行回顾性研究,分析青年组(≤35岁)和中老年组(＞35岁)乳腺癌临床病理及超声图像特征的差异.结果 青年组较中老年组癌肿组织学分级高(P=0.03)、肿瘤偏大(P＜0.01)、腋窝淋巴结易转移(P=0.03)、Ki-67表达增高(P=0.01)、三阴型多(P=0.04)、Luminal A型少(P=0.04)、肿块形状规则(P＜0.05)、后方回声无衰减或回声增强(P=0.01)、边缘无毛刺征(P＜0.01)及BI-RADS分类低(P=0.03).结论 与中老年比较,青年乳腺癌侵袭性强,预后差,但其超声表现偏向良性.

Objective To explore the diagnostic and score value of ultrasound on hemophiliac arthropathy referring to MRI on the diagnosis and score of hemophiliac arthropathy Methods The ultrasound and MRI examinations were performed on 42 joints of 42 hemophilia patients 14 knees 14 ankles and 14 elbows The consistency of ultrasound and magnetic resonance imaging in the detection and score of joint diseases was compared Finally inter-and intra-observer agreement of ultrasound scoring system were tested Results The consistency of ultrasound and magnetic resonance imaging was excellent κ=0 763-0 896 P < 0 001 in the detection of early soft tissue lesions effusion or hemarthrosis synovial hypertrophy hemosiderin excellent κ=0 793 P <0 001 in the detection of cartilage loss poor κ=0 133 P = 0 132 in the detection of erosions and poor κ= 0 100 P = 0 137 in the detection of subchondral cysts The consistency of ultrasound and magnetic resonance imaging was good to excellentκ=0 684-0 833 P < 0 001 in the score of early soft tissue lesions effusion or hemarthrosis synovial hypertrophy and hemosiderin and poor to good κ=0 145 -0 635 P <0 001 in the score of advanced osteochondral lesions cartilage loss and bone erosions The inter-observer agreement was good to excellent κ=0 676-0 870 P <0 001 for early soft tissue lesions and moderate to excellent κ=0 421- 0 75 1 P < 0 001 for advanced osteochondral lesions The intra-observer agreement was good to excellent κ=0 705-0 885 P <0 001 for early soft tissue lesions and moderate to good κ=0 532 -0 732 P <0 001 for advanced osteochondral lesions Conclusions Ultrasound plays an important role in detecting early soft tissue changes effusion or hemarthrosis synovial hypertrophy hemosiderin and cartilage loss which helps follow-up and guide clinical treatment.

从气的一元论角度介绍了癌性发热的常见病因病机,并结合自身临床实践从正虚为本、癌毒为标,实邪夹杂论述了癌性发热的不同证型、不同治法.