实时荧光定量RT-PCR检测大肠腺癌中WT1基因表达

目的探讨大肠腺癌标本中WT1基因的表达水平及其与临床病理特征的关系。方法建立实时荧光定量反转录-聚合酶链反应(RT-PCR)方法,检测了27例大肠腺癌标本和11份正常大肠黏膜组织中WT1基因及内参照β-actin基因的表达水平。结果大肠腺癌标本中WT1基因表达水平的范围5.4×10-5～8.9×10-1,在11份正常肠黏膜中有5份存在WT1的低表达,范围从7.6×10-5～7.2×10-4,其余6份未检出表达,81%(22/27)的患者癌组织中WT1 mRNA表达水平高于正常肠黏膜组织,另外,研究表明WT1 mRNA表达水平与病理分级,淋巴结转移,Duke′s分期无明显相关性。结论WT1基因在大肠腺癌中高表达,可作为诊断和治疗大肠癌新的分子指标。     

血液系统恶性肿瘤患者CD4+CD25+调节性T细胞的变化及意义

目的 分析血液系统恶性肿瘤患者外周血CD4 CD25 调节性T细胞(简称CD4 CD25 Treg)比例变化,并探讨其意义.方法 采用流式细胞术检测32例急性白血病、11例淋巴瘤患者及15例正常健康对照者外周血CD4 CD25 Treg及CD4 CD25 Foxp3 Treg细胞的比例. 结果 血液系统恶性肿瘤患者外周血CD4 CD25 Treg比例明显高于正常对照[(3.86±1.56)% vs (1.98±0.63)%,P《0.01].同时血液系统恶性肿瘤患者外周血CD4 CD25 Foxp3 Treg比例为(3.71±1.01)%,显著高于正常对照[(1.13±0.32)%,P《0.01]. 结论 血液系统恶性肿瘤患者CD4 CD25 Treg比例增高可能是患者抗肿瘤免疫功能低下的重要原因之一.     

选择性术中经胆囊管造影在腹腔镜胆囊切除术中的应用体会

目的探讨选择性术中胆道造影在腹腔镜胆囊切除术中的临床应用价值。方法回顾性分析86例经腹腔镜胆囊切除术中选择性经胆囊管插管行胆道造影的临床资料。结果术中造影发现胆总管结石73例,胆管损伤1例,副肝管2例。结论腹腔镜胆囊切除术中选择性经胆囊管行胆道造影对降低胆管结石的残留,减少不必要的胆管阴性探查,辩明胆道解剖,避免及发现胆管损伤,提高腹腔镜胆囊切除术的质量和安全性有重要价值。     

成年女性甲状腺结节良/恶性检出情况及影响因素研究

  目的   调查我国成年女性甲状腺结节患病情况及良/恶性的检出率,研究影响甲状腺结节分级的危险因素。  方法   于2018 — 2019年在山东、河南、河北和浙江省随机选择18～60岁妇女进行调查,调查内容包括膳食情况,体格检查,水样、盐样、尿样、血样等样本采集及甲状腺B超检查。 采用描述性研究、单因素logistic 回归和偏比例优势模型分析甲状腺结节检出情况及结节分级的影响因素。  结果   纳入研究的2 082人,其中无结节［甲状腺影像和数据报告系统（TI-RADS）1级］、良性结节（TI-RADS 2级）、可能是良性结节（TI-RADS 3级）、可疑或很可能是恶性结节（TI-RADS 4或5级）检出率分别为43.32%、21.23%、14.51%、20.94%。 偏比例优势模型结果显示,年龄、超重肥胖、有甲状腺疾病史对甲状腺结节良/恶性分级的影响有统计学意义（P<0.05）。  结论  年龄增大、超重和肥胖、有甲状腺疾病史是成年女性甲状腺结节良/恶性分级的危险因素,应对老年人、肥胖人群以及有甲状腺病史高危人群的甲状腺结节进行重点筛查。     

某院病案管理工作流程再造

通过分析病案管理工作中存在的环节多、经手人多、归档时间长、查找困难等问题,对病案工作管理流程进行优化。制定病案室管理条例,完善各流程工作制度和岗位职责,根据工作内容进行人员配置分工,使整个病案流程安全规范、有章可循。加强病案管理人员的责任心,提高病案工作效率和工作质量,为患者和医疗科研提供优质服务。     

经皮球囊二尖瓣成形术并发症的观察与护理

风湿性心脏病二尖瓣狭窄病理生理表现为二尖瓣瓣叶增厚、钙化、纤维化以及瓣叶交界处粘连,造成二尖瓣瓣口面积缩小（小于2 cm2）,左心房血流受阻,左心房压与肺动脉压升高,最终引起右心功能不全,临床主要表现为进行性呼吸困难,严重者可出现端坐呼吸甚至咳血。1984年,日本医生Inoue教授首先报道经皮球囊二尖瓣成形术（PBMV）[1],即利用特殊球囊的突然加压充盈,使狭窄的二尖瓣沿阻力最小的粘连交界处向瓣环方向撕裂,从而扩大瓣口面积,其方法创伤小、恢复快、疗效确切、但仍有一定并发症的发生率[2,3],本文主要阐述经皮球囊二尖瓣成形术并发症的观察与护理。     

螺纹根管钉在老年人残冠残根保留修复中的应用

目的：总结老年患者残根残冠保存修复的方法。方法：对46例老龄患者的52颗残根残冠,在行完善根管治疗的基础上行根管内螺纹桩钉,结合光固化复合树脂或银汞合金成核,然后再行金属烤瓷冠或铸造全冠修复。结果：成功47例,失败5例,成功率90．4％。结论：在完善的根管治疗基础上,应用根管螺纹钉加银汞合金或复合树脂核进行修复是保存老年人残冠残根的良好方法。     

2008年全国碘盐监测结果分析

目的 掌握我国居民层次碘盐食用情况,及时发现存在的问题,为政府制定碘缺乏病防治策略提供依据.方法 2008年,按照<全国碘缺乏病监测方案(试行)>要求,在全国31个省份以县为单位,新疆生产建设兵团以师为单位进行碘盐监测.每个县按所辖乡镇数量的不同,有9个以上乡镇的县,按东西南北中5个方位采用单纯随机抽样方法抽取9个乡、每个乡抽4个村、每个村抽8户居民;有9个和以下乡镇的县,按东西南北中5个方位各抽取1个乡、每个乡抽4个村、每个村抽15户居民.采集居民户家中的盐样进行碘盐测定,统计和分析各省居民碘盐覆盖率、碘盐合格率和合格碘盐食用率.碘盐测定采用直接滴定法,川盐及其他强化食用盐测定采用仲裁法.结果 全国共有2817个县(区、市、旗)及新疆生产建设兵团的14个师上报了监测结果,监测覆盖率99.96%(2831/2832).盐碘均数为31.51 mg/kg,有16个省份盐碘变异系数＞20.00%.共监测826 968户居民家中食用盐,其中碘盐798 725份,非碘盐28 243份,不合格碘盐20 270份.经人口加权,全国碘盐覆盖率97.48%,碘盐合格率为97.16%,合格碘盐食用率为94.79%.27个省(区、市)和新疆生产建设兵团的居民户合格碘盐食用率≥90.00%,海南、西藏、新疆、天津(省、区、市)的合格碘盐食用率＜90%.有2487个县(市、区、旗)的合格碘盐食用率≥90.00%,占实际监测县数的87.82%(2487/2831),104个县(市、区、旗)和新疆生产建设兵团的1个师碘盐覆盖率＜80.00%.结论 全国有16个省(区、市)的盐碘变异程度较高,碘盐质量有待提高.全国碘盐覆盖率和合格碘盐食用率总体较好,均≥90.00%,但海南、西藏、新疆等省(区)非碘盐情况仍然较为突出,碘盐覆盖水平较低.

Abstract：

Objective To study the national surveillance results and learn the current situation of iodized salt consumption at household level in 2008, and to find out the remaining problems and to provide scientific basis for developing control strategies against iedine deficiency disorders. Methods In 2008, in accordance with the requirements of the "National Iodine Deficiency Disorders Surveillance Program (Trial)", the surveillance was conducted at county level in 31 provinces and at division level in Xinjiang Production and Construction Corps. In each county 9 townships were randomly selected according to their sub-area positions of east, west, south, north and center;4 villages were randomly sampled in each chosen township;8 households were randomly selected in each chosen village. In every county with 9 or less townships, 1 township was randomly selected respectively in the east, west, south,north and center sub-areas;4 villages were randomly sampled in each chosen township;15 households were randomly selected in each chosen village. Edible salt from these households was collected. Iodized salt coverage rate, proportion of qualified iodized salt and consumption rate of the qualified iodized salt of the households in each province were counted and analyzed. Iodized salt was determined by direct titration;the salt samples from Sichuan and other enhanced salt were detected by arbitration. Results Totally 2817 counties (districts, cities, banners) and 14 divisions of the Xinjiang Production and Construction Corps reported the monitoring results, monitoring coverage reached 99.96%(2831/2832). Mean of iodine content was 31.51 mg/kg.Sixteen provinces had a variation coefficient of iodine content for more than 20%. A total of 826 968 households were tested of their edible salt, in which iodized salt 798 725 copies, non-iodized salt 28 243 copies, and unqualified iodized salt 20 270 copies. Weighted by population,at national level, the coverage rate of iodized salt was 97.48%, qualified rate of iodized salt 97.16%, and consumption rate of qualified iodized salt was 94.79%.Twenty seven provinces (autonomous regions and municipalities) and Xinjiang Production and Construction Corps had a qualified iodized salt coverage rate of above or equal 90.00%. Tibet, Hainan, Xinjiang and Tianjin provinces (regions) had a qualified iodized salt coverage rate lower than 90.00%. Further, 2487 counties had the rate high or equal 90.00% accounting for 87.82% (2487/2831) of complementing monitoring counties. One hundred and four counties and 1 division of the Xinjiang Production and Construction Corps had the coverage rate of iodized salt below 80.00%. Conclusions Sixteen provinces(autonomous regions and municipalities) have relatively a high degree of variation coefficient in salt iodine content. The quality of iodized salt needs to be improved. The coverage rate of iodized salt and the qualified iodized salt at national level are both above or equal 90.00%. However, the non-iodized salt problem is still serious and have a relatively lower coverage of iodized salt in Tibet, Hainan and Xinjiang.     

局麻下微创内同定治疗高龄股骨近端骨折

股骨近端骨折是骨质疏松症患者常见的并发症。由于髋部骨折严重影响患者功能活动和日常基本生活,骨折后长期卧床导致死亡和功能障碍非常高。所以近年来手术内固定治疗已成趋势。我们自2006年5月-2009年5月,尝试对9例无复杂骨折错位,体型较瘦的患者进行局麻下微创内固定治疗,术后早期床上主、被动功能锻炼,尽早坐起,疗效良好,现报道如下。     

环氧化酶-2、c-erbB-2和Ki67在结直肠癌中表达及其临床意义

目的：探讨环氧化酶-2(COX-2)、c-erbB-2、Ki67在结直肠癌中的表达,相互关系及其临床意义。方法：采用免疫组化S-P法检测结直肠癌中三者的表达。结果：结直肠癌组中,(1)COX-2、c-erbB-2蛋白阳性表达与淋巴结转移及Duckes分期有关;(2)COX-2、c-erbB-2、Ki67蛋白表达水平,两两间皆呈正相关;(3)三者联合分析显示：COX-2( )c-erbB-2( )组的Ki67平均标记指数显著高于单独COX-2或c-erbB-2阳性,或共同阴性组Ki67的表达。结论：COX-2、c-erbB-2及Ki67在结直肠癌发生发展中起着重要作用,三者联合检测有助于结直肠癌的细胞增殖活性,恶性程度的判断。