高血压病患者动态脉压与左心室肥厚的关系

OBJECTIVE: To evaluate the relationship between the left ventricular hypertrophy (LVH) and the ambulatory pulse pressure and aortic root dimension (AOD) in essential hypertensive patients. METHODS: We monitored the 24-hour ambulatory blood pressure and applied echocardiography in 107 essential hypertensive patients. Using the left ventricular mass index (LVMI) as an index in evaluating LVH, the patients were divided into 2 groups: 29 cases in the LVH group and 78 in the non-LVH group. RESULTS: The average levels of 24-hour pulse pressure, daytime pulse pressure, nighttime pulse pressure and AOD were significantly different between patients with LVH and without LVH (P < 0.05). Multiple stepwise regression analysis showed that the changes in nighttime pulse pressure and AOD were closely related to LVMI (P < 0.001). CONCLUSION: The pulse pressure and AOD are important factors leading to LVH in patients with essential hypertension.     

高原红细胞增多症患者血清尿酸水平分析

目的研究高原红细胞增多症患者(HAPC)血清尿酸(uric ac id,UA)的水平及其临床意义。方法选择HAPC患者78例,采集患者静脉血检测血清中尿酸的含量,并与80例高原健康人作对照研究。结果HAPC组血清尿酸的含量显著高于正常对照组(P<0.05)。结论在治疗高原红细胞增多症时应关注患者血尿酸水平。     

雌激素对穹隆海马伞切断大鼠脑内nAchR的干预作用

目的以双侧穹隆-海马伞切断制作阿尔茨海默病(AD)大鼠模型,观察脑内海马CA1区和皮层区烟碱型乙酰胆碱受体(nAchR)表达的变化,探讨与AD相关的发病机制,并观察雌激素的干预作用。方法健康雌性W istar大鼠,随机分为3组:(1)穹隆-海马伞切断组;(2)雌激素治疗组;(3)假手术对照组;每组大鼠5只。在脑立体定位仪上切断穹隆-海马伞,建立模拟AD动物模型。应用免疫组织化学技术观察AD大鼠海马CA1区和皮层区的nAchR阳性细胞表达的变化,以及应用外源性雌激素的干预作用。结果与对照组大鼠脑内nAchR表达比较,穹隆-海马伞切断组大鼠脑内海马CA1区、皮层区nAchR表达显著减少(P<0.05);与穹隆-海马伞切断组比较,雌激素治疗组海马CA1区、皮层区nAchR表达显著增加(P<0.01),但与对照组比较无显著差异(P>0.05)。结论穹隆-海马伞切断组大鼠脑内海马CA1区、皮层区nAchR的阳性细胞显著减少,补充外源性雌激素治疗后,上述各脑区内的nAchR表达显著增加。nAchR的变化与AD的病理变化过程密切相关,补充雌激素可以干预这种病理过程。     

Validity and reliability of the Bengali version of the Hepatitis Quality of Life Questionnaire

Purpose  

Hepatitis B virus (HBV) is endemic in Bangladesh, and the quality of life (QoL) of these patients remains unknown as there is no instrument available in the native language. In this study, we translated the 56-item Hepatitis Quality of Life Questionnaire (HQLQ) into Bengali and evaluated its validity and reliability.     

Synovial sarcoma of the temporomandibular joint area: report of a case.

Synovial cell sarcoma is a relatively rare tumor of mesenchymal origin. It is a high-grade neoplasm that microscopically shows a monophasic or biphasic cellular pattern and includes epithelial features as well as supporting tissue features. Surgical excision is the primary mode of treatment. Postoperative radiotherapy and chemotherapy also is seen to be helpful. Between 3% and 10% of cases originate in the head and neck. A review of relevant literature shows less than 10 cases of synovial cell sarcoma of the temporomandibular joint area reported in the English literature. We report an additional case of biphasic synovial cell sarcoma arising in the temporomandibular joint area, which caused ear pain, tinnitus, and hearing loss, and we further discuss the clinical features, histopathology, differential diagnosis, and treatment modality.     

超微柴胡疏肝散治疗慢性浅表性胃炎30例总结

目的：观察超微柴胡疏肝散与传统汤剂对慢性浅表性胃炎（肝胃不和型）的治疗效果。方法：治疗组30例采用超微柴胡疏肝散治疗，对照组30例采用柴胡疏肝散传统汤剂治疗。结果：两组总有效率和症状积分比较均无显著性差异（P〉0．05）。结论：两种剂型疗效相当，但超微剂型能减少用药量，节省药材。     

后腹腔镜治疗肾上腺肿瘤35例临床分析

目的总结后腹腔镜技术治疗肾上腺肿瘤的临床经验.方法采用后腹腔镜切除肾上腺肿瘤35例,男12例,女23例.年龄25岁～72岁,平均49.8岁.左侧15例,右侧20例.其中嗜铬细胞瘤5例,原发性醛固酮增多症10,柯兴氏病2例,神经节细胞瘤2例,无功能性腺瘤16例.腰部取3个套管针穿刺入路,用自制的水囊扩张器扩张后腹腔,用超声刀将肿瘤切除.结果 35例手术均成功,无中转开放手术病例.术中出血量10～500 ml,平均74 ml.病人均未输血.手术时间45～200 min,平均90 min.结论后腹腔镜手术切除肾上腺肿瘤手术效果确切,手术时间短,术中出血少,损伤小,术后恢复快,可以替代绝大多数肾上腺肿瘤开放手术.     

85例中国克罗恩病患者与68例美国克罗恩病患者的临床特征及治疗比较

目的 探讨中国与美国克罗恩（Crohn）病患者的临床特征及治疗的不同。方法 回顾性分析解放军总医院（301医院）1985～2004年收治的85例Crohn病患者与美国克利夫兰医院（CCF）1985～2004年收治的68例Crohn病患者的临床资料，两组计数资料比较采用χ^2检验。结果 301医院Crohn病患者的男女比为1．74：1，CCF为1：1．43。CCF患者的家族史阳性率和肠外表现发生率均高于301医院（P〈0．05）。301医院患者中病变累及回肠末端者（69．41％）较多，无一例累及肛周，临床表现以溃疡（65．88％）和上皮样肉芽肿（34．12％）多见，溃疡、肠腔梗阻发生率高于CCF患者（P〈0．05）。CCF患者中累及结肠及直肠的病例较多，肛周瘘管或直肠阴道瘘（51．47％）较多见，肛周病变、腹腔内瘘发生率显著高于301医院（P〈0．05）。301医院药物治疗以柳氮磺吡啶（54．12％）、5-氨基水杨酸（18．82％）及甲硝唑（21．18％）为主，CCF以激素（60．29％）、硫唑嘌呤（33．82％）、infliximab（45．59％）为主。CCF手术治疗患者明显多于301医院（P〈0．01）。结论 301医院与CCF的Crohn病患者临床特征存在差异，这是两者在治疗时采取不同措施的原因之一。     

原发性乳腺恶性淋巴瘤的诊断及外科治疗探讨

目的探讨原发性乳腺恶性淋巴瘤的诊断与治疗. 方法回顾性分析我院1992～2004年5例原发性乳腺恶性淋巴瘤的临床资料.5例均为术后组织学病理诊断.4例行乳腺癌改良根治术,1例行乳房单纯切除术.5例均行化疗及放疗. 结果乳腺癌改良根治术手术时间60～120 min,平均80 min;乳房单纯切除术加乳腔镜腋窝淋巴结清扫术手术时间75 min.术中出血量150～250 ml,平均200 ml.术后病理组织诊断均为弥漫性非霍奇金氏淋巴瘤,为B细胞来源.且均有腋窝淋巴结转移.全组病例随访6个月～12年,平均4.5年.2例II期,均死于肿瘤多器官转移;3例I期,肿瘤无复发. 结论原发性乳腺恶性淋巴瘤无明显特异性表现,术前诊断困难.钼靶X线照相,对诊断有帮助. 治疗可选择手术、放疗、化疗或单纯给予化疗和放疗.