通过对比分析浸润性小叶癌和浸润性导管癌的临床特点和超声表现,分析两者的异同,提高浸润性小叶癌的超声诊断的准确率.回顾性分析2016年12月—2021年12月在山东大学第二医院术前行超声检查并经术后病理证实为浸润性小叶癌的70个结节和浸润性导管癌的731个结节,通过单因素及多因素分析,评估两组间的异同,明确各超声征象的诊断价值.两组在年龄、绝经状态、厚径、长/厚、病变类型、触诊、导管异常、形态及边缘表现等方面差异有统计学意义(P＜0.05).将上述因素作为自变量纳入多因素Logistic回归模型,结果显示,模型具有统计学意义(x2=7.383,P＜0.001,R2=0.082).年龄较小]者(OR=1.025)、长/厚较大者倾向于浸润性小叶癌(OR=0.619).尽管多种临床和超声表现在诊断浸润性小叶癌时可以起到一定的作用,但病例年龄和病灶长/厚比值在单因素和多因素中都有重要意义,对浸润性小叶癌和导管癌的鉴别诊断有重要意义.

Ulcerative colitis（UC） is a recurrent long-term delay chronic non-specific inflammatory bowel disease with the main clinical manifestations of diarrhea, mucous bloody stools, and abdominal pain and tenesmus. Classical prescriptions from traditional Chinese medicine（TCM） is effective in the treatment of UC, and it has the advantages of multi-target regulation and small toxic and side effects.Studies showed that several classical prescriptions from TCM could play a crucial role in the prevention and treatment of UC by regulating anti-inflammation, regulating immunity, regulating intestinal flora, and protecting intestinal mucosal barrier. Based on the systematic review of the common TCM syndrome types and main TCM rules of treatment, seven TCM syndrome types including large intestine damp-heat syndrome, spleen deficiency damp-obstruction syndrome, spleen and kidney yang deficiency syndrome, liver stagnation and spleen deficiency syndrome, blood stasis in the intestinal collateral syndrome, cold and heat mixed syndrome, excessive heat-poison syndrome in the diagnosis and treatment of UC in recent years were reviewed and summarized. From this, seven common rules of treatment were concluded under the guidance of TCM syndrome differentiation thinking, which include clearing away heat and dampness, regulating qi and blood; invigorating spleen and replenishing qi, removing dampness and stopping diarrhea, invigorating spleen and warming kidney, warming yang and removing dampness, soothing the liver and regulating qi, invigorating the spleen and the middle, promoting blood circulation by removing blood stasis, regulating intestine and dredging collaterals, warming the middle and tonifying deficiency, clearing away heat and eliminating dampeness, clearing heat and detoxicating, cooling blood and stopping diarrhea. At the same time, the pharmacological characteristics, mechanisms and clinical application of 16 classical prescriptions and four Chinese patent medicines are summarized, to establish a scientific system of pharmacologic characteristics and clinical efficacy evaluation of classical prescriptions and Chinese patent medicine for the treatment of UC under the guidance of TCM syndrome differentiation theory, and promote the rational application and innovative development of classical prescriptions and Chinese patent medicine in the field of clinical treatment of UC from the source.

目的 探讨负性生活事件、反刍和睡眠质量对病区护士情绪状态的影响路径,为减少负性生活事件、反刍和睡眠质量对情绪状态的不良影响提供决策依据.方法 采用广泛性焦虑量表(GAD-7)、抑郁症筛查量表(PHQ-9)、反刍量表(RRS)、匹兹堡睡眠质量指数(PSQI)和生活事件量表对某三级甲等综合医院850名病区护士进行问卷调查,采用SPSS 22.0和AMOS 21.0进行统计学分析及结构方程模型拟合.结果 焦虑、抑郁与负性生活事件、反刍和睡眠质量呈正相关(r=0.25～0.75,P<0.01),负性生活事件可以直接对情绪状态产生影响,也可以通过反刍、睡眠质量间接对情绪状态产生间接影响,其对情绪状态影响的总效应为0.34,其中直接效应为0.09,占总效应的26.47％;通过其他路径产生的间接效应为0.25,占总效应的73.53％.结论 负性生活事件、反刍和睡眠质量对其情绪状态的影响存在多条作用路径.