目的 探讨经阴道B型超声（B超）在诊断早期宫外孕中的临床应用价值。 方法 回顾分析2011年5月－2012年3月应用阴道B超与腹部B超对78例宫外孕患者进行对比检查的临床资料并回顾性分析，评价两种检查方法的临床效果。 结果 78例宫外孕患者，应用经阴道B超检查诊断准确率为97.44%，应用腹部B超准确率为61.54%，差异具有统计学意义（χ2=6.472，P＜0.05）；经阴道B超检查诊断附件包块、宫内假孕囊、心血管搏动、胚芽、盆腔积液的检出率明显高于经腹部B 超检查的检出率（P＜0.05）。 结论 阴道B超具有操作简单、快速、无副作用、无需充盈膀胱等优点，在宫外孕的早期诊断中具有绝对的优越性，为临床提供了更方便、更快捷的诊断手段，减轻了患者痛苦，提高了诊断的准确率，值得临床广泛推广和应用。
【摘要】 目的 探讨乳腺浸润性导管癌中表皮钙黏蛋白（E-cadherin，E-cad）的表达及其意义。 方法 选取2005年1月－2009年12月的组织病理切块，用免疫组织化学EnVision二步法检测63例乳腺浸润性导管癌（invasive ductal carcinoma，IDC）组织中E-cad的表达情况，设为IDC组；另检测15例乳腺纤维腺瘤及15例乳腺小叶增生症乳腺组织中E-cad的表达情况，设为对照组；比较两组的E-cad表达。 结果 E-cad在IDC组及对照组中表达阳性率分别为58.7%、80.0%；两组间差异有统计学意义（Plt;0.05）。在乳腺IDC患者中，年龄lt;38岁和≥38岁组的E-cad阳性表达率分别是54.2%、61.5%，两组间差异无统计学意义（Pgt;0.05）；肿块直径lt;3 cm和≥3 cm组的E-cad阳性表达率分别是54.8%、66.7%，两组间差异无统计学意义（Pgt;0.05）；组织学分级为Ⅰ+Ⅱ级和Ⅲ级组的E-cad阳性表达率分别是76.3%、32.0%，两组间差异有统计学意义（Plt;0.05）；无、有腋窝淋巴结转移组的E-cad阳性表达率分别是78.3%、47.5%，两组间差异有统计学意义（Plt;0.05）。 结论 E-cad的表达与患者年龄及肿块大小无关，而与组织学分级、淋巴结转移相关。在乳腺浸润性导管癌中，无淋巴结转移者E-cad表达高于有淋巴结转移者，提示E-cad是乳腺浸润性导管癌发生淋巴结转移的重要指标。【Abstract】 Objective To explore the expression of the protein E-cadherin (E-cad) in invasive ductal carcinoma (IDC) of the breast and its significance. Methods We chose 63 cases of pathological wax with IDC between 2005 and 2009, and immunohistochemical EnVision method was used to detect the expression of E-cad protein in these cases which were designated to be the IDC group. At the same time, the E-cad expression in 15 cases of breast adenoma and another 15 cases of breast lobular hyperplasia were also detected, and these cases were designed to the the control group. The expression of E-cad in these two groups were compared. Results The positive rates of E-cad protein expression in the IDC group and the control group were respectively 58.7% and 80.0% with a significant difference between the two groups (Plt;0.05). In the IDC group, the positive rates of E-cad protein expression in patients agedlt;38 and ≥38 years old were respectively 54.2% and 61.5% without a significant difference (Pgt;0.05). The positive rates of E-cad protein expression for tumors with a diameter lt;3 cm and ≥3 cm were respectively 54.8% and 66.7% without a significant difference (Pgt;0.05). The positive rates of E-cad protein expression for class Ⅰ+Ⅱ tumors and class Ⅲ tumors were respectively 76.3% and 32.0% with a significant difference (Plt;0.05). The positive rates of E-cad protein expression for patients without and with axillary lymph node metastasis were respectively 78.3% and 47.5% with a significant difference (Plt;0.05). Conclusions The expression of E-cad is correlated with histological classification and lymph node metastasis and was not related to tumor size and age of the patients. The expression of E-cad is higher in IDC patients without lymph node metastasis than that in IDC patients with lymph node metastasis, which indicates that E-cad is an important index for lymph node metastasis of IDC.
目的：评价低分子肝素(Low molecular weight heparins，LMWH)皮下注射持续时间对注射后皮下出血和疼痛的影响。方法：纳入2003年～2004年3月于我院行LMWH皮下注射的住院患者52例，以肚脐两侧作为注射点，任选一侧行首次注射，12 h后于另一侧以相同剂量注射。脐右注射持续10秒(对照组)，脐左持续30秒(实验组)。于注射后48 h、72 h观察注射点有无皮下出血，并用透明纸质毫米尺测量出血面积，用视觉类比量表(Visual analog scale，VAS)测量疼痛强度，记录疼痛持续时间。采用卡方检验及配对t检验对两组皮下出血发生率及面积、疼痛强度及持续时间等指标进行对比分析。结果：实验组和对照组皮下出血的发生率分别为38.5%(n=20)和61.5%(n=32)(P=0.035)。注射后48h、72h，实验组的出血面积均显著低于对照组(48h：17.5±7.3 mm2 VS 101.2±15.0 mm2，P=0.008；72h：20.7±8.0 mm2 VS 110.4±13.5 mm2，P=0.016)。实验组的注射后疼痛积分为13.0±6.4 mm，对照组为21.5±7.0 mm(P=0.021)。实验组疼痛持续时间显著低于对照组(42.5±14.2 s比73.2±20.0 s，P=0.030)。结论：肝素皮下注射持续时间能显著影响注射后皮下出血和疼痛形成，注射时间持续至30秒能有效降低皮下出血发生率及面积，并显著减轻疼痛强度、缩短疼痛时间。
ObjectiveTo explore the effect of precise management on life-saving equipment management in Surgical Intensive Care Unit (SICU). MethodsWe actualized precise management in the life-saving equipment management process in March 2014, including precise management control system, precise personnel training, and precise process management. ResultsAfter precise management, the knowledgement of life-saving equipment of the nurses increased from 90.2% (May, 2014) to 98.5%. The number of equipments repaired before (March-May, 2014) and after the management (June-August, 2014) was 65 and 47, respectively; the number of nonstandard management times in nurses after the equipments were used was 98 and 10, respectively. ConclusionPrecise management can drastically improve management efficiency, serviceability rate and service efficiency of life-saving equipment, obviously enhancing the degree of familiarity and using skills of clinical nurses, and ensuring quick and smooth emergency work. It plays an active role in securing severe patients' life.
目的 探讨不同年龄段老年骨折合并高血压的动态血压变化，评估心脑血管事件发生风险。 方法 将2009年4月－2012年2月入住的184例60岁以上老年骨折合并高血压患者分为低龄老年骨折组（97例，60～79岁）与高龄老年骨折组（87例，≥80岁），对每位患者行动态血压分析。 结果 两组患者平均收缩压均升高，差异无统计学意义（P＞0.05）；但高龄老年骨折组平均舒张压和平均脉压差在全天、日间及夜间均低于低龄老年骨折组，差异有统计学意义（P＜0.05）；高龄老年骨折组血压节律紊乱更明显，心脑血管事件发生率明显高于低龄老年骨折组，差异有统计学意义（P＜ 0.05）。 结论 高龄老年骨折患者血压节律紊乱明显，应及时调整并制定有效的个体化降压方案，积极防止以及血管事情的发生。
FromJune1989toMarch1998,11casesofprimaryhyperparathyroidism(PHP)hadbeentreatedsurgicallyin .thishospital.Thepreoperativelocalizationof9caseswereachievedbyoneortwononinvasivetechniquesincludingultrasonography,computedtomography,colorDopplerimagingand99mTcMIBIscintigraphy.Parathyroidectomyweredonesuccessfullyin10of11caseswiththepathologicalresultsofadenomain10casesandonenormalparathyroid.Theauthorsemphasize①earlyrecognitionanddiagnosiswhichcanbehelpedbythenoninvasivetechniquesmentionedaboveforlocalization,②familiaritywiththelocalanatomyespeciallyfortheectopicparathyroidtogetherwithfrozensectionbiopsyduringoperation,and③intensivemedicalcareaftersurgeryandfollowupsoastoheightenthecapacityofdiagnosisandtreatmentofthisdisease.