目的 探讨剪切波弹性成像技术(SWE)对伴有钙化的乳腺肿块的诊断价值.方法 收集2020年1月-2022年2月在我院收治的201例女性患者临床资料,共205个乳腺肿块.纳入伴有钙化且BI-RADS分类结果为4a及以上的乳腺肿块193个,其中良性110个,恶性83个.使用SWE技术比较最大弹性值(Emax)和平均弹性值(Emean)在良恶性组中的差异,分析SWE的诊断效能.结果 恶性组的Emax和Emean值高于良性组,差异有统计学意义(P＜0.01);Emax和Emean两个指标具有较高的特异度和阳性预测值,分别为 90.91％、87.01％及 93.64％、90.00％.Emax 和 Emean 的 AUC 值分别为 0.92(0.89～0.96)和 0.91(0.87～0.95),两者具有良好且相似的诊断效能.结论 SWE对所有伴钙化的乳腺肿块具有良好的诊断效能,Emax与Emean两弹性指标的特异度均较高,在保证灵敏度的同时,其特异度的提高有利于减少对可疑结节的穿刺活检.

目的 探讨剪切波弹性成像(SWE)评价单侧腰椎间盘突出(LDH)患者坐骨神经改变的价值.方法 选取2019年10月-2021年3月我院就诊的60例经临床和磁共振成像(MRI)诊断为单侧LDH的患者为LDH组,30例健康受试者为对照组,测量两组受试者坐骨神经的杨氏模量均值(Emean)及横截面积(CSA),并比较各参数的差异.绘制ROC曲线,分析各参数对LDH的诊断效能.结果 LDH组患侧坐骨神经的CSA值和Emean高于对侧及对照组,差异有统计学意义(P<0.05);ROC曲线分析显示,CSA诊断LDH受压患侧坐骨神经的截断值为54.83 mm2,敏感性为71.70％,特异性为63.30％.Emean诊断LDH患侧坐骨神经的截断值为14.42 kPa,敏感性为95.00％,特异性为96.70％.结论 单侧LDH患者患侧坐骨神经的CSA和硬度增加,Emean较CSA的诊断价值更高,SWE可作为评价单侧LDH患者患侧坐骨神经的一种辅助诊断方法.

目的 利用剪切波弹性成像技术评估乳腺肿块的各向异性,探讨各向异性因子(AF)及其联合BI-RADS分类对乳腺肿块的诊断价值.方法 收集102例患者共106个肿块在最大径线及垂直切面的弹性定量指标,分析AFs及其联合BI-RADS分类对乳腺良恶性肿块的诊断价值.结果 恶性肿块的AFs明显高于良性肿块(P＜0.05).BI-RADS分类及AFratio诊断的灵敏度、特异度、准确度、Kappa值分别为85.4％、75.9％、80.2％、0.605及72.9％、86.2％、80.2％、0.597.二者联合诊断的灵敏度、特异度、准确度、Kappa值分别为83.3％、89.7％、86.8％、0.733.联合诊断的Kappa值最高,特异度较单一BI-RADS分类高(x2=3.876,P=0.049＜0.05).结论 AF可作为乳腺癌的诊断指标,AFratio联合BI-RADS分类可提高乳腺肿块诊断的特异度及可靠性,有一定的应用价值,值得进一步研究.

目的 观察放射状与反放射状切面的实时剪切波弹性成像技术(SWE)在乳腺肿块定性及定量诊断中的价值.方法 选取2019年9月～12月于安徽医科大学第一附属医院就诊的116例乳腺肿块患者,共122枚肿块,比较放射状与反放射状切面上SWE的定性(硬缘征)及定量(Emax、Emean、SD、Eratio)结果 ,以病理检查为金标准,构建SWE定量结果 诊断乳腺肿块的ROC曲线,比较两切面各指标对乳腺肿块的诊断价值.结果 两个切面的SWE硬缘征出现频率比较,差异无统计学意义(P>0.05);两个切面SWE定性诊断的敏感性、特异性及准确度比较,差异无统计学意义(P>0.05);放射状与反放射状切面上的Eratio比较,差异有统计学意义(P<0.05),其诊断乳腺肿块的AUC分别为0.793与0.782,差异无统计学意义(P>0.05);两切面上其他定量指标及其诊断乳腺肿块的AUC比较,差异均无统计学意义(P>0.05).结论 放射状与反放射状的切面选择会对SWE定性及定量诊断乳腺肿块产生一定的影响,但不会影响各指标的诊断效能.

Objective To investigate the effects of inhalation of nicotine on cardiovascular function, oxidative stress and inflammation in rats and its mechanism. Methods Forty healthy male SD rats were randomly divided into four groups. The experimental group was inhaled nicotine by air-purging. The rats were exposed for 1 h, 2 h and 4 h daily, respectively, and were determined as low, medium and high dose groups. The control group was housed un-der standard conditions. After 90 days, aortic reactivity and blood pressure were measured. The levels of endotheli-al NO synthase(eNOS), interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α) and interleukin-10 (IL-10) in heart, lung tissue and serum of rats were measured. Serum nitric oxide ( NO ) content, malondialdehyde ( MDA) content, superoxide dismutase ( SOD) activity and glutathione peroxidase ( GSH-Px) activity were meas-ured respectively. Results Compared with the control group, the blood pressure of the experimental group was sig-nificantly increased. NO, eNOS and MDA content were significantly decreased. GSH-Px activity was significantly increased. The levels of IL-1β, TNF-α, IL-10 were significantly increased in heart, lung and serum respectively. Conclusion Long-term inhaled nicotine by air-purged impaired cardiac function and caused high blood pressure, induced oxidative stress and cardiopulmonary inflammatory reaction. The mechanism may be related to endothelial dysfunction and simultaneous activation of sympathetic and parasympathetic systems.

AIM:To establish an experimental device to test the nicotine concentration of cigarette smoke.METHODS:The nicotine concentration and peak area linear equation were established by GC-MS.It was used to determine the different flow rates of air for the carrier gas purge of liquid nicotine formation of aerosol nicotine concentration.Serum cotinine concentration in rats was determined by ELISA.RESULTS:In the range of 0.226 0 to2.269 7 μg/m L, the nicotine peak area showed a good linear relationship with its mass concentration, and the correlation coefficient (r2= 0.993 7).The average recoveries were 97.2％, 113.7％, and108.1％, respectively, with standard gaseous nicotine concentrations of 0.567 4, 1.134 8, and1.702 3 μg/m L, respectively.The relative standard deviations (RSD) were 6.1％ and 20.8％, 16.9％, respectively (n = 3).The retention time of standard and e-cigarette nicotine was 13.41 min.Fragment quantification ion m/z 84.03 and auxiliary quantification ion m/z 133.03 appeared.The specificity of the method was good.Electronic cigarette smoke nicotine concentration was 0.584 μg/m L.Conditions:25 ℃ nicotine liquid height of 20 cm, air flow 1.1 L/min, the experimental device aerosol nicotine concentration and electronic cigarette smoke matched.Compared with the control group (2.05 ±0.83) ng/m L, the serum cotinine concentration in the nicotine group was significantly higher (5.31 ±0.62) ng/m L (P ＜ 0.01).CONCLUSION:An experimental device is established to test the nicotine concentration of the electronic cigarette smoke, which can infect rats with nicotine.