Endoscopic brush cytology for diagnosis of malignant biliary stricture / 中华消化内镜杂志

Objective To evaluate brush cytology under endoscopic retrograde cholangiopancreatography (ERCP) for malignant biliary strictures, and to analyze the factors influencing the diagnosis yield.Methods Brush cytology was applied in 144 patients with suspected malignant biliary strictures at ERCP.Brushing in bile duct was performed for 10 times from 2004 to 2006, while at least 20 times of brushing and repeated manipulation were performed at biliary strictures from 2007 to 2009. Cytological samples were processed immediately after brushing and analyzed by the same pathologist. Efficacy of brush diagnosis was evaluated based on reference to histopathology after surgery and/or clinical diagnostic criteria. Results Malignant stricture was finally diagnosed in 96 patients, and benign diseases in other 48. Brush cytology was positive in 78 of 96 patients with malignant stricture ( sensitivity 81.3% ), and negative in all patients without malignancy ( specificity 100. 0% ). Overall accuracy of diagnosis was 87.5%. Positive rate of malignancy by brush between 2007 and 2009 was 87.7% (50/57), while that between 2004 and 2006 was 71.8%, which were significantly different ( P ＜ 0. 05 ). The positive rate was not correlated with stricture location or tumor type. No major complications occurred, except for 4 moderate acute pancreatitis, 3 cholangiolitis and 2 biliary bleeding. Conclusion Brush cytology is of high sensitivity and specificity for malignant biliary stricture.Repeated brushing and manipulation can facilitate diagnosis yield.

Clinical value of transvaginal Doppler ultrasound in diagnosing ectopic oviduct-pregnancy / 中国基层医药

Objective To explore clinical value of transvagiTIa ultrasound in diagnosis of cctopie oviductpregnancy.Methods EUB-2000 ultrasound diagnosis meter was used,the vagina probe head frequency is 5～10MHz,after the vagina to the womb,the double-side ovary,the double side oviduct and its periphery organizes to carry on omni-direetionally sweeps looks up.Results Transvagina ultrasound diagnosis ectopic pregnancy center oviduct pot abdomen pregnancy 158 cases,the oviduct canyon department 4 cases,between the oviduct the nature department pregnancy 2 cases,all pass through the cefioseope of our hospital.Coincidence rate was 100%.Conclusion Transvagina ultrasound diagnosis ectopie pregnancy is one of most accurate ultrasound diagnosis methods presendy,suggested various basic units hospital widely develops.