二维b超对乳腺癌筛查的临床诊断价值

研究临床乳腺癌筛查使用二维b超检查的诊出率,并为适龄女性乳腺癌筛查和防治提供建议。方法:提取我院2019年1月-2020年12月开展免费乳腺癌筛查项目的检查数据,分析二维b超检查的检出率,比较两年间乳腺癌筛查趋势。结果:我院2019年1月-2020年12月接受免费乳腺癌筛查的女性2518例,进行临床乳腺检查和二维b超检查。2019年-2020年乳腺二维超声检查按照BI-RADS分级分为0-5级,其中0-3级的检查率为8.33%,4-5级的检查率为0.399%。病理学检查率由2019年的0.467%提高到了1.198%;两年共检出浸润性导管癌2例。2019年浸润性导管癌检出率0.718%(1/1393),2020年浸润性导管癌检出率0.889%(1/1125)(X2=0.314,P>0.05)。两年检出率上升趋势不明显。 结论:临床乳腺癌筛查中使用二维b超检查能有效筛查出乳腺癌及相关乳腺疾病,为广大女性普及乳腺癌预防知识,提高女性乳腺癌筛查意识,提供了有效途径,有效做到了妇女乳腺癌筛查应检尽检,早发现早治疗。

Efficacy of intraductal ultrasonography in the diagnosis of non-opaque choledocholith

AIM: To evaluate the efficacy of intraductal ultrasonography (IDUS) in the diagnosis of non-opaque, common bile duct stones. METHODS: A total of 183 patients (102 males, mean age 73 years; 81 females, mean age 70 years) with suspected common bile duct stones diagnosed through abdominal computed tomography (CT), magnetic resonance imaging (MRI), and abdominal Type-B ultrasound were included in the study. The diagnosis was confirmed through endoscopic retrograde cholangiopancreatography (ERCP) followed by IDUS. RESULTS: A total of 183 patients with suspected common bile duct (CBD) stones were included in the study as follows: 36 patients with high-density CBD stones, 68 patients with sand-like stones, 44 patients with low-density stones, 21 patients with ampullary cancer, and 14 patients with pancreatic cancer. Conventional imaging revealed 124 cases of choledochectasia, and only 36 cases of suspected CBD stones; ERCP revealed 145 cases of CBD stones with three missed diagnoses. IDUS revealed 148 cases of CBD stones, 21 cases of ampullary tumors, and 14 cases of pancreatic cancer. CONCLUSION: IDUS was more effective in the diagnosis of bile duct stones than ERCP, upper abdominal CT or upper abdominal MRI.

Electro-acupuncture Treatment for the Upper Segment Ureterolithiasis Under B-Ultrasonography

In order to explore the effects of the local strong stimulation generated by electro-acupuncture for treatment of the upper segment ureterolithiasis,a controlled study was carded out among the treatment group (electro-acupuncture with strong stimulation),the control group Ⅰ(medication) and the control group Ⅱ (conventional acupuncture).The results showed that the differences in the cure rate and the total effective rate between the treatment group and the two control groups were significant in statistical analysis (P<0.05 and P<0.01 respectively).This indicates that better therapeutic effects can be obtained by the local strong stimulation generated by electro-acupuncture for treatment of the upper segment ureterolithiasis.

Non-alcoholic fatty liver disease and metabolic syndrome in obese children

I read with great interest the article of Fu et al who investigated whether non-alcoholic fatty liver disease(NAFLD)is an early mediator for prediction of metabolic syndrome,and whether liver B-ultrasound could be used for its diagnosis,in a study involving 861 obese children(6-16 years old).In this study,it was reported that NAFLD is not only a liver disease,but also an early mediator that reflects metabolic disorder,and that liver B-ultrasound can be a useful tool for metabolic syndrome(MS)screening.The authors reported that NAFLD and MS were present in 68.18%and 25.67%of obese children,respectively.Moreover,they observed that the prevalence of MS in NAFLD children was 37.64%,which was much higher than that in the non-NAFLD group.Criteria analogous to those of the Adult Treatment PanelⅢdefinition for MS were used for children in this study.The reported prevalence data on MS in the young has varied markedly,in large part because of disagreement among the variously proposed definitions of MS.Therefore,in my opinion,a study aiming to assess the association between MS components and NAFLD in obese children has to take into account a simple,easy-to-apply clinical definition proposed by the international diabetes federation for MS.Interpretation of the results of the Fu et al study are limited byanother major caveat:that the diagnosis or exclusion of NAFLD was based on liver enzymes and ultrasound imaging,but was not confirmed by liver biopsy.Indeed,it is known that liver enzymes may be within the reference interval in up to 70%of patients with diagnosed NAFLD and that the full histopathological spectrum of NAFLD may be present in patients with normal liver enzymes,which therefore cannot be reliably used to exclude the presence of NAFLD.

DIAGNOSIS AND TREATMENT OF PHEOCHROMOCYTOMAS IN URINARY BLADDER

Objective To investigate the diagnosis and treatment of pheochromocytomas in urinary bladder and review relative literatures. Methods The clinical data of 6 cases of bladder pheochromocytoma were retrospectively analyzed. Bladder submucosal mass was detected by B-ultrasound in 6 cases, computerized tomography （CT） in 4, and cystoscopy in 3. All patients were treated with surgical operation. Results Two patients showed obvious fluctuation of blood pressure during operation. All patients were pathologically diagnosed as pheochromocytoma postoperatively. Five patients were followed up （from 3 months to 7 years） , and their blood pressure returned to normal. No patient had relapse and malignancy. Conclusion Typical hypertension during urination and hematuria constitute the chief symptoms of bladder pheochromocytoma. B-ultrasound, CT, and cystoscopy are the main methods for the localization of the lesions. Partial cystectomy or excision of the tumor is the preferred management and postoperative long-term follow-up is necessary.