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find Keyword "鉴别诊断" 69 results
  • Value of Ultrasonography in Diagnosis and Differentiation of Tumors of Adrenal Gland

    【摘要】 目的 探讨超声显像对肾上腺肿瘤的定位、定性诊断与鉴别诊断价值。 方法 对 2003年1月-2009年1月125例疑为肾上腺肿瘤患者进行超声及CT检查,并经手术与病理证实。超声显像诊断后经手术与病理证实为嗜铬细胞瘤48例,肾上腺皮质腺瘤41例,皮质腺癌11例,肾上腺转移癌 9例,髓样脂肪瘤8例,结节样增生2例,肾上腺结核4例,胰尾部肿瘤1例,肝脏肿瘤1例,肾上极肿瘤1例。 结果 肾上腺肿瘤的病理类型不同,声像图表现亦各不相同。超声显像定位诊断符合率为96.0%(120/125),定性诊断符合率为91.2% (114/125)。 结论 超声显像对肾上腺肿瘤的定位与定性诊断价值较大,可作为临床诊断的首选检查方法。【Abstract】 Objective To assess the value of ultrasonography in the diagnosis and differential diagnosis of tumors of adrenal gland. Methods From January 2003 to January 2009, 125 patients who were suspected to suffering from adrenal tumors underwent ultrasonography and CT examination. The results were then confirmed by surgery and pathology. There were 48 cases of pheochromocytoma, 41 adenoma, 11 adenocarcinoma, 9 metastatic tumor, 8 adrenal medullary lipoma, 2 nubblar hyperplasia, 4 tuberculosis of adrenal gland, 1 tumor of cauda pancreatic, 1 tumor of liver and 1 tumor of upper pole of kidney. Results The ultrasonographic features varied with different pathological types. The accuracy diagnosis of localizition and qualitation were 96.0% (120/125) and 91.2% (114/125) respectively. Conclusion Ultrasonography is useful in diagnosing tumors of adrenal gland, which may be used as the first choice for the disease.

    Release date:2016-09-08 09:50 Export PDF Favorites Scan
  • Diagnostic Value of Vascular Endothelial Growth Factor in Differentiation of Malignant Ascites: A Meta-analysis

    Objective To establish the overall diagnostic accuracy of the measurements of vascular endothelial growth factor (VEGF) for malignant ascites. Methods After a systematic review of current studies, sensitivity, specificity, and other measures of the value of ascites concentrations of VEGF in the diagnosis of malignant ascites were pooled by using random effects models. Qualified studies on evaluation of VEGF in diagnosis of malignant ascites in English and Chinese published from January 1990 to December 2009 were retrieved from The Cochrane Library, Cochrane Central Register of Controlled Trials, MEDLINE, EMbase, China National Knowledge Infrastructure (CNKI) databases, WanFang Data, and VIP Information. Two reviewers independently assessed the methodological quality of each study with the tool of QUADAS. Statistical analyses were performed by employing Meta-Disc 1.4 software. Meta-analyses of the reported sensitivity and specificity of each study and Summary Receiver Operating Characteristic (SROC) curve were performed. Results Seven studies met the inclusion criteria for the analysis. After testing the heterogeneity of the included studies, a random effect model was selected to calculate the pool weighted sensitivity and specificity with 95% confidence interval: the sensitivity was 0.81 (95%CI 0.75 to 0.85), the specificity was 0.90 (95%CI 0.86 to 0.94), the DOR was 50.45 (95%CI 28.37 to 89.73), and the AUC of SROC was 0.9507 (SE=0.013 0). The subgroups were analyzed to identify the sources of heterogeneity according to race and agent sources. There was homogeneity among the three studies with agents from Ramp;D company (χ2=0.05, P=0.9750; I2=0.0%), and the AUC of SROC were 0.9675 (SE=0.016 7). Conclusion VEGF has a highly accurate sensitivity and specificity with a b ROC curve, which makes it a new marker to differentiate malignant ascites from the benign.

    Release date:2016-09-07 11:02 Export PDF Favorites Scan
  • 老年支气管哮喘的诊断与鉴别诊断

    在发达国家, 老年支气管哮喘( 简称老年哮喘)的患病率高达6% , 且在该老年人群尚存在不少未诊断的哮喘[ 1, 2 ] 。在64 ~75 岁人群中, 女性偏多,75 岁以上则没有明显的性别差异。因哮喘导致的死亡, 有2 /3 系65 岁以上的患者所构成, 其可能与高龄、精神因素( 抑郁/ 焦虑) 、吸烟、心血管、肺、肾等基础疾病等危险因素有关。老年哮喘用于门诊、住院治疗、健康保健、共病( co-morbidity) 处理的医疗资源亦明显高于青年哮喘[ 3, 4 ] 。所以, 老年哮喘目前已愈来愈受到世界的关注[ 5, 6 ] 。......

    Release date:2016-09-13 04:00 Export PDF Favorites Scan
  • 心因性非癫痫性发作患者和癫痫患者心理治疗期间发作的频率及管理

    越来越多的证据表明,心理治疗可有效改善癫痫和心因性非痫性发作(Psychogenic nonepileptic seizures,PNES)的预后。然而,治疗期间发作的风险可能引发对治疗安全性和发作导致治疗中断的担忧。研究探讨癫痫和 PNES 患者的发作风险、心理治疗期间发作的时间以及心理治疗师应对发作的措施。研究纳入了连续在英国两个神经病学中心接受心理治疗的癫痫和 PNES 患者。采用一个包含 12 项信息的调研表格收集患者在门诊心理治疗期间发作的信息。研究共评估了 97 例癫痫患者和 195 例 PNES 患者。1/32 的癫痫患者和 1/8 的 PNES 患者在治疗期间至少有 1 次发作。癫痫患者出现发作的疗程占总疗程的 1/136,PNES 患者出现发作的疗程占总疗程的 1/36。PNES 患者治疗期间发作的风险显著高于癫痫患者[(OR=4.4,95%CI(1.3,15.2)]。发作往往发生于整个治疗的前半部分和个别治疗期,且仅短暂中断治疗。仅有 1 例 PNES 患者需住院观察,但无需留院过夜。心理治疗期间确实会出现发作,且 PNES 患者比癫痫患者更为常见。发作较少对心理治疗造成重大干扰,治疗师多可在没有额外医务人员帮助的情况下进行治疗。尽管如此,该研究表明心理治疗师应预测治疗期间发作的风险并制定安全的管理计划。PNES 患者在治疗期间发作频率较高,有助于我们理解其诱导发作的机制。

    Release date:2019-07-15 02:48 Export PDF Favorites Scan
  • Villoglandular Carcinoma of Cervix: A Clinicopathological Analysis

    ObjectiveTo investigate the clinicopathological features, diagnosis and differential diagnosis of villoglandular carcinoma of the uterine cervix. MethodsThe clinical data of a 34-year-old patient diagnosed with villoglandular carcinoma of cervix on April 6, 2010 was retrospectively analyzed. Surgical excision samples were analyzed by means of hematoxylin-eosin and immunohistochemical staining. ResultsThe gross appearance of the tumor mass showed cauliflower-like pattern of growth. Histologically, it was similar to colorectal villoglandular adenoma, and was composed of branching papillae shaped like villous glandular tube structure, and the surface was coated with pseudostratified or stratified columnar cells which showed mild atypia and uncommon mitotic figures. Immunohistochemically, tumor cells were positive for carcinoma embryonic antigen, CK7 and CA125, and negative for estrogen receptor, progesterone receptor, P16, p53 and vimentin. This patient was subjected to a follow-up of 48 months, and was alive without recurrence or metastasis. ConclusionsVilloglandular carcinoma of the uterine cervix is rare and has a favorable prognosis. The diagnosis of villoglandular carcinoma depends on pathological morphology, and meanwhile, it is necessary to distinguish villoglandular carcinoma from other benign and malignant tumors which exhibited papillary growth pattern.

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  • Clinical Significance of Serum VEGF-C Level and C-erbB-2 Protein Expression in Patients with Breast Cancer

    Objective To investigate clinical significance of serum VEGF-C level and C-erbB-2 protein expression in patients with breast cancer. Methods Sixty-two female patients with breast invasive ductal cancer and breast benign lesion were respectively selected. Serum VEGF-C level was detected by enzyme-linked immunosorbent assay (ELISA) before operation and at one month after operation, and C-erbB-2 protein expression in tissues of breast cancer was detected by immunohistochemistry. Then, the relationship between serum VEGF-C level and clinicopathologic characteristics and C-erbB-2 protein expressions wereas analyzed. Results The serum VEGF-C level before operation in breast cancer patients〔(279.65±17.34) pg/ml〕 was significantly higher than that in breast benign lesions patients 〔(167.26±12.15) pg/ml〕, P<0.01. In breast cancer patients, the serum VEGF-C level before operation was higher than that at one month after operation 〔(209.45±15.23) pg/ml〕, P<0.01. The serum VEGF level was related to tumor stage (P<0.05) but not to patient age, tumor size, menopause status , lymph node metastasis or not and ER and PR expression (Pgt;0.05). The positive expression rate of C-erbB-2 protein in breast cancer patients (54.84%, 34/62) was significantly higher than that in breast benign lesion patients (11.29%, 7/62), P<0.01. Moreover, the positive expression rate of C-erbB-2 protein in breast cancer patients with axilla lymph node metastasis (69.44%) was significantly higher than that without axilla lymph node metastases (34.62%), P<0.05. The serum VEGF level increased with increasing expression intensity of C-erbB-2 protein and there was positive correlation between them (r=0.813,P<0.05). Conclusions The serum VEGF-C level in breast cancer may be conducted as an assisted marker to differential diagnosis of breast tumor. C-erbB-2 is related to lymph node metastasis of breast cancer patients. There is synergistic effect between VEGF-C and C-erbB-2 in the lymph node metastasis way of breast cancer.

    Release date:2016-09-08 11:05 Export PDF Favorites Scan
  • 神经衰弱的鉴别诊断模式

    【摘要】为探讨神经衰弱鉴别诊断的规范化方法,提高其准确性。 将必备组合症状、病因、内在关系、严重程度、病程、排除症状和非器质性病变基础七方面做为神经衰弱鉴别诊断模式的要素,用神经症二重辩证施治进行临床验证。验证表明,神经衰弱与伴发神经衰弱症状的其他疾病相比,具有明显的差异。其中必备组合症状、病因和内在关系,是鉴别诊断的核心;排除症状、非器质性病变基础是重要参考标准,但在某些特定情况下是否成为鉴别诊断的依据,应视情况而定;严重程度和病程仍有意义。神经衰弱的鉴别诊断模式具备了更加缜密规范准确的优点。

    Release date:2016-09-08 09:51 Export PDF Favorites Scan
  • Application value of three-dimensional contrast-enhanced ultrasound angiography in differential diagnosis of breast masses

    Objective To explore the value of three-dimensional contrast-enhanced ultrasound angiography in the differential diagnosis of breast masses. Methods A total of 120 patients with breast masses who were treated in our hospital from July 2013 to February 2016 were selected as the research objects retrospectively, including 70 patients of benign tumor (benign group) and 50 patients of malignant tumor (malignant group) that confirmed by surgery and pathology. All patients were given conventional two-dimensional ultrasound and three-dimensional contrast-enhanced ultrasound angiography during the diagnosis. Compared the imaging features of benign group and malignant group, and compared the diagnostic value of two-dimensional ultrasound and three-dimensional contrast-enhanced ultrasound angiography for breast masses. Results Compared with benign group, the rates of irregular masses, unclear boundary, inhomogeneous echo, lateral shadowing, echo attenuation, and micro calcification in the malignant group were all higher (P<0.05). The three-dimensional contrast-enhanced ultrasound angiography scores in malignant group and benign group were significantly different with each other (P<0.05), the score of the malignant group was higher than that of benign group. The 2- and 3-score was common in benign group, but 4- and 5-score was common in malignant group. The diagnostic sensitivity of two-dimensional ultrasound and three-dimensional contrast-enhanced ultrasound angiography for breast masses were 97.1% (68/70) and 98.6% (69/70) respectively, and the specificity were 80.0% (40/50) and 96.0% (48/50) respectively, the specificity of three-dimensional contrast-enhanced ultrasound angiography was significantly higher than that of two-dimensional ultrasound (P<0.05). Conclusion Two-dimensional ultrasound and three-dimensional contrast-enhanced ultrasound angiography both have a certain diagnostic value in the differential diagnosis of breast masses, but the three dimensional contrast-enhanced ultrasound angiography can get more information through assessment of richness of the microvascular in tumor tissue, so as to improve the diagnostic specificity and is worthy of popularization and application.

    Release date:2017-04-01 08:56 Export PDF Favorites Scan
  • Typical imaging features of hepatic angiomyolipoma: “rapid wash-in and wash-out”, but not hepatocellular carcinoma

    Hepatic angiomyolipoma (HAML) is a rare benign mesenchymal tumor of the liver, which has highly variable imaging appearances, often leads to missed diagnosis and misdiagnosis. The images of 2 patients with HAML confirmed by pathology were presented in this study, and the typical imaging features of the HAML, the underlying pathophysiological mechanism, and the differential diagnosis were briefly summarized so as to deepen the understanding of HAML and to improve the diagnosis and differential diagnosis abilities of HAML, then reduce the rates of missed diagnosis and misdiagnosis of the HAML.

    Release date:2023-03-22 09:25 Export PDF Favorites Scan
  • The Pleomorphic Liposarcoma of Galactophore

    目的 探讨乳腺脂肪肉瘤的临床病理特点及鉴别诊断。 方法 分析2010年3月收治的1例乳腺多形性脂肪肉瘤的临床表现、组织病理学特征及免疫表型特点,并复习相关文献。 结果 肿瘤由高级别多形性肉瘤和数量不等的多形性脂肪母细胞组成。免疫组织化学:肿瘤细胞呈S-100蛋白阳性表达、CD34灶性阳性表达,细胞角蛋白、上皮膜抗原、巨噬细胞表面抗原、结蛋白、平滑肌肌动蛋白、肌调节蛋白、肌浆蛋白、CD31均呈阴性表达。结论 乳腺脂肪肉瘤是一种少见的原发于乳腺的间叶源性肿瘤,诊断上应首先排除乳腺化生性癌和恶性叶状肿瘤伴脂肪肉瘤分化,应依据形态学特点和免疫组织化学结果进行鉴别。

    Release date:2016-09-08 09:12 Export PDF Favorites Scan
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