经阴道入路直肠肿瘤切除术二例

报告2例女性患者经阴道人路进行直肠肿瘤切除术即经自然腔道内镜手术（NOTES）的经过和术后情况。2例患者均为直肠肿瘤,先后于2010年6月8日和2010年8月10日实施NOTES直肠肿瘤切除。手术除脐部这一天然皱褶外,在腹部未使用辅助Trocar,术中使用常规腹腔镜器械,术后腹部无可见的瘢痕。病理诊断分别为直肠管状绒毛状腺瘤和直肠浸润型中分化腺癌。目前,2例患者均已恢复正常工作和生活,夫妻双方性生活均无不适感。     

慈溪市25～55岁居民高血压患病情况及其原因分析

目的:了解慈溪市25～55岁居民高血压患病情况及相关的危险因素,为制定高血压防治措施提供依据。方法:进行整群随机抽样,调查2010年慈溪市城乡25周岁以上的常住人口。调查内容包括:性别、年龄、体重指数、生活习惯及其受教育程度等。结果:慈溪市城乡25～55岁居民高血压患病率为11.44%,其中城市为10.17%,乡村为13.02%。随年龄增大而逐渐增高,35岁以上患病率上升幅度明显。高血压危险因素有年龄、超重或肥胖(BMI≥25)、腹型肥胖、高脂血症、高钠饮食、饮酒偏多等。保护因素有受教育程度、素食偏多等。结论:慈溪市25～55岁居民高血压患病率呈较快上升趋势,主要危险因素为年龄、高脂血症、超重、腹型肥胖、饮酒偏多。     

从中医体质学说研究老年中风病

中风是目前严重危害人类健康和生命的疾病之一,具有发病率高、致残率高、死亡率高的特点。老年中风病发病与体质有着密切的关系,体质影响疾病的易感性,影响疾病的病理变化与证候类型,影响疾病的转归及预后。通过研究老年中风病患者的体质特点,并对其进行预防、治疗和调护,可以降低发病率、致残率、死亡率,提高人们的健康水平。     

ZEB1的表达与肺鳞状细胞癌侵袭及转移的关系

目的：探讨锌指E-盒结合同源异形盒-1 (ZEB1)在肺鳞状细胞癌组织中的表达,分析ZEB1 mRNA和蛋白的表达水平与肺鳞状细胞癌侵袭及转移的关系。方法：选择45例肺鳞状细胞癌行外科手术切除的患者,根据所取组织与肿瘤的距离不同分为肺鳞状细胞癌组织和癌旁正常肺组织,采用RT-PCR和Western blotting方法检测肺鳞状细胞癌组织和癌旁正常肺组织中ZEB1 mRNA和蛋白的表达情况,并分析肺鳞状细胞癌不同临床病理特征ZEB1 mRNA和蛋白的表达差异;构建ZEB1特异性siRNA载体,感染肺癌NCI-H2170细胞,设未转染对照组、转染照组和ZEB1 siRNA转染组,应用Western blotting方法从蛋白质水平检测各组干扰质粒对ZEB1基因的干扰效果,通过Transwell侵袭小室观察各组NCI-H2170细胞侵袭能力的变化。结果： ZEB1 mRNA在肺鳞状细胞癌组织中的阳性表达率显著高于癌旁正常肺组织（P＜0.05）;在淋巴结转移、远处转移阳性者肺癌组织中的阳性表达率显著高于其在淋巴结转移、远处转
移阴性者肺癌组织中的表达（P<0.05）;但ZEB1 mRNA的表达与肺鳞状细胞癌患者的性别、年龄及肿瘤大小及分化程度无关(P>0.05)。肺鳞状细胞癌组织中ZEB1蛋白的表达与ZEB1 mRNA的表达结果类似,ZEB1蛋白在肺鳞状细胞癌组织中的表达量显著高于癌旁正常肺组织（P<0.05）;在淋巴结转移和远处转移阳性者癌组织中的表达显著高于其在淋巴结转移和远处转移阴性者癌组织中的表达（P<0.05）。下调NCI-H2170细胞中ZEB1蛋白的表达后,NCI-H2
170细胞的侵袭及转移能力明显降低（P<0.05）。结论：ZEB1在肺鳞状细胞癌组织中高表达,表达变化与肺鳞状细胞癌的病理特征密切相关;运用RNA干扰技术有效沉默NCI-H2170细胞的ZEB1基因后,可显著降低NCI-H2170细胞的侵袭及转移能力,提示ZEB1在肺癌的发生发展中起重要作用,抑制ZEB1的表达可能成为一种治疗肺癌的方法。
     

创伤性膈疝24例临床分析

目的探讨创伤性膈疝的诊断及治疗方法。方法回顾性分析24例创伤性膈疝患者的致伤原因及诊断、治疗过程。结果 24例创伤性膈疝患者均行手术治疗,治愈22例,死亡2例,治愈率91.7%。结论对胸腹部创伤患者详细询问受伤情况,全面体格检查,根据X线、CT和临床特点多能得到早期诊断,及时手术治疗是提高治愈率的关键。     

Bioequivalence studies of 2 oral cefaclor capsule formulations in chinese healthy subjects

An open-label, single-dose, randomized, crossover study was carried out in 20 Chinese healthy male subjects to compare the pharmacokinetics of 2 cefaclor (CAS 53994-73-3) formulations after administration of a single 250 mg dose of each drug with a 1-week wash-out period. Blood samples were collected before and with 6 h after drug administration. Plasma concentrations were determined by high-performance liquid chromatography (HPLC) with UV detector. 2 formulations were evaluated using the following pharmacokinetic parameters: AUC0-t, Cmax and tmax was analyzed nonparametrically. The 90% confidence interval (CI) of the ratios (teat/reference) of log-transformed AUC0-t and Cmax fell within the bioequivalence acceptance range of 80-125%. The results showed that the 90% CI of the ratios of AUC0-t and Cmax were 105.1% (101.0-109.4%) and 92.4% (82.5-103.4%), respectively, which therefore could conclude 2 oral cefaclor capsule formulations of cefaclor are bioequivalent. Both treatments showed similar tolerability and safety.     

In vivo optical virtual biopsy of human oral mucosa with harmonic generation microscopy

Recent clinical studies on human skin indicated that in vivo multi-harmonic generation microscopy (HGM) can achieve sub-micron resolution for histopathological analysis with a high penetration depth and leave no energy or photodamages in the interacted tissues. It is thus highly desired to apply HGM for in vivo mucosa histopathological diagnosis. In this paper, the first in vivo optical virtual biopsy of human oral mucosa by using epi-HGM is demonstrated. We modified an upright microscope to rotate the angle of objective for in vivo observation. Our clinical study reveals the capability of HGM to in vivo image cell distributions in human oral mucosa, including epithelium and lamina propria with a high penetration depth greater than 280 μm and a high spatial resolution better than 500 nm. We also found that the third-harmonic-generation (THG) contrast on nucleus depends strongly on its thicknesses, in agreement with a numerical simulation. Besides, 4% acetic acid was found to be able to enhance the THG contrast of nucleus in oral mucosa, while such enhancement was found to decay due to the metabolic clearance of the contrast enhancer by the oral mucosa. Our clinical study indicated that, the combined epi-THG and epi-second-harmonic-generation (SHG) microscopy is a promising imaging tool for in vivo noninvasive optical virtual biopsy and disease diagnosis in human mucosa.     

Widespread cortical thinning in children with frontal lobe epilepsy

Purpose: Spread of seizure activity outside the frontal lobe due to cortico‐cortical connections can result in alteration in the cortex beyond the frontal lobe in children with intractable frontal lobe epilepsy (FLE). The aim of this study was to identify regions of reduced cortical thickness in children with intractable FLE. Methods: High‐resolution volumetric T₁‐weighted imaging was performed on 17 children with FLE, who were being evaluated for epilepsy surgery, and 26 age‐matched healthy controls. The cortical thickness of 12 patients with left FLE and 5 patients with right FLE was compared to controls. The clusters of cortical thinning were regressed against age of seizure onset, duration of epilepsy, seizure frequency, and number of medications. Key Findings: In children with left FLE, cortical thinning was present in the left superior frontal, paracentral, precuneus, cingulate, inferior parietal, supramarginal, postcentral, and superior temporal gyri, as well as in the right superior and middle frontal, medial orbitofrontal, supramarginal, postcentral, banks of superior temporal sulcus, and parahippocampal gyri. In children with right FLE, cortical thinning was present in the right precentral, postcentral, transverse temporal, parahippocampal, lingual, and lateral occipital gyri, as well as in the left superior frontal, inferior parietal, postcentral, superior temporal, posterior cingulate, and lingual gyri. In children with left FLE, following exclusion of one outlier, there was no significant association between age at seizure onset, duration of epilepsy, seizure frequency and number of medications with clusters of cortical thinning. In children with right FLE, age at seizure onset, duration of epilepsy, frequency of seizures, and number of medications were not associated with clusters of cortical thinning within the right and left hemispheres. Significance: Cortical changes were present in the frontal and extrafrontal cortex in children with intractable FLE. These changes may be related to spread of seizure activity, large epileptogenic zones involving both frontal and extrafrontal lobes, and development of secondary epileptogenic zones that over time lead to cortical abnormality. Further studies correlating cortical changes with neurocognitive measures are needed to determine if the cortical changes relate to cognitive function.     

Surgical treatment of developmental dysplasia of the hip presenting in children above 10 years

Background  

Management of developmental dysplasia of the hip in older children remains controversial. The objective of this study was to evaluate the results of surgical treatment of developmental dysplasia of the hip in children older than 10 years.