目的 探讨胸腰椎爆裂性骨折(TLBF)应用经伤椎椎弓根钉固定结合经椎弓根植骨治疗的临床效果。方法 选取我院2013年7月—2016年7月收治的28例TLBF患者,均行经伤椎椎弓根钉固定结合经椎弓根植骨治疗。详细记录所有患者术中出血量、手术时间及住院时间等围术期情况;比较28例患者手术前后影像学指标、腰背部疼痛视觉模拟评分法(VAS)评分及Frankel分级;随访期间并发症情况。结果 与术前相比,28例患者术后1个月、3个月时的椎体前后缘高度、Cobb角及VAS评分,均更优(P<0.01);经Ridit分析知,28例患者术后6个月时Frankel分级显著优于术前(P<0.01);术后随访6个月期间内,未见内固定松动、断裂等情况,且并未发生因椎弓根植骨而引起的神经症状。结论 TLBF应用经伤椎椎弓根钉固定结合经椎弓根植骨治疗能有效复原与保持脊柱生物力学稳定性,矫正后凸畸形,减少患者术后痛苦与并发症,改善神经功能,安全可靠,具有较高临床推广价值。

Objective To investigate the effects of the pedicle screw fixation combined with pedicle bone graft in treatment of thoracolumbar burst fracture(TLBF). Methods Selected 28 patients with TLBF treated in our hospital from July, 2013 to July, 2016, all of whom were treated with the pedicle screw fixation combined with pedicle screw fixation in the treatment of vertebral pedicle screw fixation. Recorded all patients' detailed situations on preoperative period of bleeding volume, operation time and length of stays. Compared 28 patients' imaging parameters, back pain visual analogue scale (VAS) score and Frankel classification before and after operation. And to observe the complications during follow-up as well. Results Compared with the pre-operation, 28 patients' anterior and posterior margin height, Cobb angle and VAS score were significantly better (P<0.01) than that of one month and three months after the operation. According to the Ridit analysis, six months after the operation, 28 patients' Frankel classification was better than that of pre-operation (P<0.01). No internal fixation loosening or breakage was found during the follow-up period of 6 months, and there was no nerve symptoms caused by pedicle screw fixation. Conclusion The pedicle screw fixation combined with pedicle screw fixation in treatment of thoracolumbar burst fracture(TLBF) can effectively restore and maintain the biomechanical stability of the spine, correct kyphosis, reduce postoperative pain and complications, improve nerve function and be safe and reliable,have higher clinical value.

目的 通过B超检查,掌握九龙镇农村已婚育龄妇女常见病的患病情况,总结和分析B超在普查中的应用价值。方法 对自愿参加普查的2775名20~59岁九龙镇育龄妇女进行子宫、附件的常规B超检查,对检出的妇科疾病进行统计分析。结果 在普查中检出多种妇科疾病,前三位的是子宫肌瘤、宫颈囊肿及附件包块;年龄段分布情况中,40~49岁居首位、30~39岁次之。结论 定期对农村育龄妇女进行B超普查是早期发现、早期诊断妇科病最简便、最有效的检查方法,在临床中具有重要的应用价值。

目的 研究乳管镜在乳头溢液的诊断中的应用价值。方法 回顾性分析2010年2月－2014年3月采用乳管镜检查的123例乳头溢液患者的临床资料。结果 乳管镜检查发现乳腺导管癌8例,导管内乳头状瘤33例,乳头状瘤病32例,导管扩张及炎症35例。术后病理检查证实乳腺导管癌5例,导管内乳头状瘤35例,乳头状瘤病30例,导管扩张及炎症33例。结论 乳管镜可作为诊治乳头溢液的首选措施,其所起到的作用是超声、钼靶及乳管造影所不及的。

Objective To study the clinical application value of the fiberoptic ductoscopy(FDS) on the diagnosis of nipple discharge. Methods A retrospective analysis of 123 patients with nipple discharge undergoing FDS from February 2010 to March 2014. Results After fiberoptic ductoscopy examination,it was found there were 8 cases of breast cancer,33 cases of intra-duct papilloma,35 cases of papillomatosis,35 cases of dilatation and inflammation. However there were 5 cases of breast cancer,35 cases of intra-duct papilloma,30 cases of papillomatosis, and 33 cases of dilatation and inflammation were comfirmed through postoperative pathological examination. Conclusion Fiberoptic ductoscopy is more effective than B-ultrasonography and Mo-traget mammography, so it can be the preferred method of diagnosis and treatment for nipple discharge.

       目的   分析早期结直肠癌内镜下治疗前行窄带成像结合放大内镜 （ME-NBI）和超声内镜技术的评估价值。方法   采用回顾性分析方法，以2021年1月— 2023 年 12月中山市第五人民医院收治的102例早期结直肠癌患者为观察对象，所有患者均接受内镜下黏膜切除术（EMR）或内镜黏膜下剥离术（ESD）治疗，根据内镜下治疗前是否进行ME-NBI和超声内镜检查分为研究组与对照组各51例。比较两组年龄、性别、肿瘤大小、直乙结肠占比及组织病理特征；比较两组治疗时间、ESD治疗后非治愈性切除发生率、治愈性切除率、并发症发生情况及再次ESD或外科手术治疗率。结果   两组年龄、性别、肿瘤大小、直乙结肠占比及组织病理比较差异均无统计学意义（P＞0.05）。研究组中37例行ESD治疗，治疗时间为（120.6±140.3）min，12例行EMR治疗，治疗时间为（11.6±9.3）min，有2例不符合内镜下治疗指征，转外科手术治疗。对照组有38例行ESD治疗，治疗时间为（128.8±144.5）min，13例行EMR治疗，治疗时间为（12.5±9.5）min，两者治疗时间比较差异均无统计学意义（P＞0.05）。研究组非治愈性切除率为7.84，低于对照组27.45；治愈性切除率为88.24，高于对照组72.55；研究组ESD手术并发症为8.11%，低于对照组31.58；ESD或外科手术率为6.12，低于对照组25.49（P＜0.05），结论  ME-NBI和超声内镜对早期结直肠癌患者行内镜下治疗指征评估更准确，可提高治愈性切除率。

       Objective  To  study the application value of magnifying endoscopy combined with  narrow  band imaging （ME-NBI）and ultrasonic endoscopy system before endoscopic treatment in patients with early colorectal cancer．Methods  A retrospective analysis was carried out on  102  patients with early-stage colorectal cancer who were admitted to Zhongshan Fifth People’s Hospital from January 2021 to December 2023．All patients were treated with endoscopic mucosal resection（EMR）or endoscopic submucosal dissection（ESO）．The patients were divided into study group（51 cases）and control group（51 cases）according to whether ME-NBI and ultrasonic endoscopy was performed before endoscopic treatment or not．The patient age，sex，volume of tumor，location of tumor and pathological result of the tumor were compared between two groups．Time for treatment，curative resection rate，non-curative resection rate and the complication incidence of ESD，incidences of second ESD or surgery were compared between the two groups．Results  There were no statistical differences in age，sex，volume of tumor，location of tumor and pathological result of the tumor（P＞0.05）．In the study group，37 patients received ESD treatment，operation time was（120.6±140.3）minutes，and 12 patients received EMR treatment，operation time was（11.6±9.3）minutes，two cases were transferred to surgery due to endoscopic ultrasonography combined with magnifying endoscopy showed that they did not meet the indications for ESD treatment．In the control group，38 patients received ESD treatment，operation time was（128.8±144.5）minutes，13 patients received EMR treatment，operation time was（12.5±9.5）minutes．There was no significant difference in treatment duration between the two groups．The non-curative resection rate of the study group was 7.84%，which was significantly lower than that in the control group（27.45%），and the curative resection rate（88.24%）was significantly higher than that in the control group（72.55%）．The complications of ESD surgery in the study group were 8.11%，lower than 31.58% in the control group．The rate of second ESD or surgery was 6.12%，lower than 25.49% in the control group（P＜0.05）．Conclusions  ME-NBI and endoscopic ultrasound are more accurate in the evaluation of endoscopic indications for early colorectal cancer patients，and can improve the curative resection rate．

       目的     探讨CT增强延迟扫描技术在非小细胞肺癌术前诊断中的应用价值。方法    对2021年5月—2024年5月商丘市第一人民医院收治的82例非小细胞肺癌手术治疗患者进行回顾性分析，将其分为观察组，另选取82例肺部良性肿瘤患者作为对照组，收集其术前CT增强延迟扫描结果，以术后病理诊断结果为金标准，分析CT增强延迟扫描技术在非小细胞肺癌术前诊断中的应用价值。并对比不同临床病理特征非小细胞肺癌患者CT增强延迟扫描的CT增强值，采用Spearman相关性分析法分析CT增强值与非小细胞肺癌病理特征的关系。结果  CT增强延迟扫描显示观察组患者分叶征（12.50% vs 53.57%）、内部空泡征数量（6.25% vs 39.29%）低于对照组（χ ² =26.560、24.680，P＜0.05），观察组患者边缘毛刺（56.25% vs 17.86%）、胸部凹陷征（59.38% vs 14.29%）、高于对照组（χ ² =43.330、64.600，P＜0.05）；82例非小细胞肺癌通过CT增强延迟扫描共确诊79例，CT增强延迟扫描诊断对非小细胞肺癌的准确率为96.34%（79/82），与病理诊断结果100.00%对比差异无统计学意义（χ ² =3.060，P=0.080）；82例非小细胞肺癌平均CT增强值为（39.14±7.31），不同性别、年龄、肿瘤最大直径、淋巴结浸润情况患者CT增强值对比差异无统计学意义（P＞0.05），不同病理类型［腺癌（43.75±7.15）vs 鳞癌（34.74±6.12）］、细胞分化程度［中、低分化（45.71±7.21）vs 高分化（32.81±5.11）］、临床分期［Ⅰ期（31.03±2.12）vs Ⅱ期（36.61±3.13）vs Ⅲa期（46.32±6.83）］患者、淋巴结转移［是（42.75±4.21）vs 否（35.77±8.13）］CT增强值对比差异有统计学意义（t/F=5.243、8.804、84.828、4.378，P＜0.05）；Spearman相关分析结果显示：病理类型、细胞分化程度、临床分期、淋巴结转移与非小细胞肺癌患者CT增强值呈正相关（r=0.431，P=0.021；r=0.511，P=0.009；r=0.586，P=0.005；r=0.579，P=0.008，P＜0.05）。结论  CT增强延迟扫描技术对非小细胞肺癌术前确诊具有重要价值，其诊断准确率与病理诊断并无显著差异，且可通过CT增强延迟扫描技术确定患者CT增强值，从而为非小细胞肺癌患者术后病理特征判断提供参考。

      Objective  To explore the application value of CT enhanced  delayed  scanning in  preoperative  diagnosis of non-small cell lung cancer（NSCLC）．Methods  A retrospective analysis was conducted on 82 patients with NSCLCwho underwent surgical treatment in a hospital from May 2021 to May 2024．They were included into  an  observation  group and another 82 patients with benign lung tumors were included in the control group．The  preoperative CT enhanced  delayed scanning results were collected，and the postoperative pathological diagnosis was used as the “gold standard” to analyze the application value of CT enhanced delayed scanning in the preoperative diagnosis of NSCLC．And the CT enhancement values of delayed CT scans in NSCLC patients with different clinical and pathological features were compared，and Spearman correlation analysis was used to analyze the relationship between CT enhancement values and pathological features of NSCLC．Results  CT enhanced delayed scanning showed that the number of lobular（12.50% vs 53.57%）and internal vacuolar signs（6.25% vs39.29%）in the observation group was significantly lower than that in the control group（χ ² =26.560，24.680，P＜0.05），while the edge spicules（56.25% vs 17.86%）and chest depression signs（59.38% vs 14.29%）in the observation group were significantly higher than that in the control group（χ ² =43.330，64.600，P＜0.05）．A total of 79 cases of 82 NSCLC were diagnosed by CT-enhanced delayed scan，and the accuracy of CT-enhanced delayed scan diagnosis for NSCLC was 96.34%（79/82），with no significant difference from the pathological diagnosis result of 100.00%（χ ² =3.060，P=0.080）．The average CT enhancement value of 82 NSCLC cases was（39.14±7.31）．There was no significant difference in CT enhancement values among patients of different genders，ages，maximum tumor diameter，and lymph node infiltration（P＞0.05）．Patients with different pathological types ［adenocarcinoma（43.75±7.15）vs squamous cell carcinoma（34.74±6.12）］，degree of cell differentiation ［moderate，and low differentiation（45.7±7.21）vs high differentiation（32.81±5.11）］，clinical stage ［I（31.03±2.12）vs II（36.61±3.13）vs IIIa（46.32±6.83）］ and lymph node metastasis ［yes（42.75±4.21），vs no（35.77±8.13）］ CT enhancement had significant difference（t/F=5.243，8.804，84.828，4.378，P＜0.05）．The Spearman correlation analysis results showed that pathological type，degree of cell differentiation，clinical stage，lymph node metastasis were positively correlated with CT enhancement values in NSCLC patients（r=0.431，P=0.021；r=0.511，P=0.009；r=0.586，P=0.005；r=0.579，P=0.008）．Conclusions  CT enhanced delayed scanning has important value in preoperative diagnosis of NSCLC．Its diagnostic accuracy is not significantly different from pathological diagnosis，and the CT enhanced value of patients can be determined through CT enhanced delayed scanning，providing reference for postoperative pathological feature judgment of NSCLC patients．