输尿管息肉的诊断与治疗(附9例报告)

目的：探讨输尿管息肉的诊断与治疗方法。方法：回顾性分析9例输尿管息肉患者的临床资料，结合文献进行讨论。结果：9例患者中，4例行息肉切除加基底部电灼，2例行息肉切除输尿管肾盂吻合术，2例行病变段输尿管切除再吻合术，1例行肾切除术。全部病例均获治愈并经病理证实。结论：放射学检查是诊断输尿管息肉的主要方法，其特征是边缘光滑锐利的充盈缺损。输尿管息肉的治疗以手术为主，应根据息肉的大小，数量，部位及肾脏受累程度选择局部切除术，输尿部分切除术和肾盂成形术等。     

基质金属蛋白酶与肺癌转移的关系

基质金属蛋白酶(matrix metalloproteinases，MMPs)是一组锌离子依赖的蛋白水解酶，在ECM降解中起着重要作用。目前研究表明，MMPs活性异常不仅能促进肿瘤血管形成，还是人类多种肿瘤侵袭和转移的必要条件。本文就与肺癌侵袭和转移有关的MMPs研究作一综述。     

二维彩色多普勒显像在下肢静脉血栓诊断中的应用

目的:探讨二维(2-DE)彩色多普勒显像(CDF1)在下肢静脉血栓中的诊断及治疗效果观察中的应用价值。方法:应用ACUSON-128XP10及GE-VIVID7超声仪对来自于血管外科73例98人次(111条)下肢静脉血栓病人进行检查。结果:下肢深静脉完全阻塞57例(62条),部分阻塞3例(4条),少部分再通(<50％)18人次(23条),大部分再通(75％)15人次(17条),完全再通2人次(2条),其中再通人次包含治疗后复查的部分二次及三次复检者及来诊时即为部分再通者。另外,有3例(3条)合并大隐静脉曲张及血栓形成。结论:二维彩色多普勒显像对下肢静脉血栓的阻塞程度、范围及治疗后再通情况可做出较为肯定的诊断,对指导下肢静脉血栓的治疗及预后判断具有重要价值。     

MR灌注成像在评估脑胶质瘤放疗效果中的应用

目的探讨MR灌注成像在评估脑胶质瘤放疗疗效中的应用价值。方法对25例脑胶质瘤术后患者于放疗前及放疗后3、6个月行MR灌注成像及常规MRI检查。由灌注数据获取脑血容量（CBV）图和脑血流量（CBF）图。计算出病灶的最大相对局部脑血容量（rCBV）值和最大相对局部脑血流量（rCBF）值。结果25例脑胶质瘤术后放疗前肿瘤区的rCBV值和rCBF值分别为6．32±2．14和5．49±1．98，与正常脑组织的2．58±1．21和2．17±1．19相比，显著升高（P〈0．01）。其中11例放疗后rCBV值和rCBF值与放疗前相比，显著下降（P〈0．01），其中5例证实为放射性脑坏死；另14例放疗后rCBV值和rCBF值与放疗前相比，有不同程度升高，但无统计学意义（P〉9．05）。其中7例证实为肿瘤伴部分放射性坏死组织，2例死亡，5例再次行放射治疗取得较好疗效。结论MR灌注成像可作为评估脑胶质瘤放疗疗效的一项重要指标。并有助于下一步治疗方案的制定。     

超声抽吸法治疗下肢原发性淋巴水肿

目的观察超声抽吸法治疗下肢原发性淋巴水肿的疗效。方法为12例患者采用内超声脂肪抽吸机吸除淋巴水肿组织以降低患肢淋巴负荷，抽吸后结合持续弹力袜裤压扎。结果术后2周水肿即时消退明显，术后1年随访水肿消退，复发不明显。结论超声抽吸法治疗原发性淋巴水肿安全简便，结合弹性袜裤压扎可望取得较好的远期疗效。     

PTEN与基质金属蛋白酶在胃癌组织中的表达及意义

目的:探讨PTEN与基质金属蛋白酶(MMP)在胃癌组织中的表达、相互关系及意义。方法:应用免疫组化SP技术检测80例胃癌组织中PTEN、MMP2和MMP9表达,同时检测20例正常对照组胃粘膜中PTEN表达。结果:胃癌组织中PTEN高表达率35／80(43.8％)显著低于对照组20／20(100. 0％)(P<0.01);PTEN表达与胃癌分化程度、浸润深度、淋巴结转移和肿瘤分期显著相关;胃癌组织中 MMP2、MMP9阳性表达率分别为41／80(51.3％)、29／80(36．3％),与胃癌浸润深度、淋巴结转移和肿瘤分期显著相关;PTEN与MMP2、MMP9表达显著负相关,与病人预后相关,Kaplan-Meier生存曲线分析显示PTEN高表达者术后累计生存率显著高于低表达者,PTEN高表达者术后3年、5年生存率显著高于低表达者;MMP2、MMP9阳性表达者术后累计生存率显著低于阴性表达者,MMP2、MMP9阳性表达者术后3年、5年生存率显著低于阴性表达者。结论:胃癌组织中PTEN表达显著减少,PTEN 与MMP2、MMP9表达显著负相关,PTEN可能通过调控胃癌组织MMP2、MMP9表达,抑制胃癌的浸润和转移,影响病人的预后。     

Outpatient Initiation of Insulin: A Nurse Practitioner Protocol

Noninsulin dependent diabetes (type II diabetes) is a chronic disease characterized by hyperglycemia. Clients can generally be controlled by diet and exercise or a combination of diet, exercise, and oral hypoglycemic agents. When this therapy is not effective in controlling the hyperglycemia, the health care provider must choose to initiate insulin therapy. Outpatient initiation of insulin is an alternative to hospitalization in the type II diabetic client. Clinical guidelines for the initiation of insulin on an outpatient basis and management of the diabetic client are presented.     

山医群体中国地鼠近交E家系RAPD分析

目的　分析山医群体中国地鼠E家系的遗传纯度。方法　应用经过筛选的 3 1条随机引物对中国地鼠E家系 12只个体基因组DNA进行RAPD扩增 ,计算近交个体间的相似系数。结果　所有样品的相似系数0 943 1到 0 9978之间变动 ,平均相似系数为 0 9749,聚类分析得到了这些个体的同源树资料。结论　山医群体E家系有较高的遗传纯度     

环戊硫酮治疗干眼的临床疗效评价

Objective To investigate anethol trithione therapic efficiency on dry eye. Methods It was a prospective random double-blind controlled study. Eighty cases diagnosed dry eye in Ocular Surface Out-patient Clinic of Xiamen University Affiliated Xiamen Eye Center from 2006 to 2008 were divided into two groups: anethol trithione group and control group, 40 cases in each group. Every group was then divided into two subgroups: weak dry eye subgroup, middle and severe dry eye subgroup. All groups had been added with 0.05% refresh drops. All patients had been detected and evaluated by subjective symptoms of dry eye, visual acuity,corneal fluorescent staining(F1), break-up time(BUT) and Schirmer Ⅰ test (SⅠT) at pre-therapy and 3,7,28 d of post-therapy. All groups had been compared and analyzed by F test and sample mean difference (SMD) or median difference (MD) comparison between pre-therapy and post-therapy. Results Except of tear and red eye, the other subjective symptoms of dry eye, F1, BUT and SⅠT of weak dry eye subgroup of both groups had been improved at 7 d after therapy. Only those of middle and severe dry eye subgroup of anethol trithione group had been improved at 7 d after therapy compared with those of pre-therapy: SMD=0.96 (visual tiredness), 1.26 (dry and unsmooth sensation), 0.82 (foreign body sensation), 1.28 (burning sensation), 1.05 (photophobia), 1.48 ( pain ) ; MD=0.30 (visual acuity), 4.00 (F1) ,5.00 (BUT), 5.00 (SⅠT) [F=15.30 (visual tiredness), 15.68 (dry and unsmooth sensation ), 13.56 (foreign body sensation), 20. 91 ( burning sensation ), 18.90 (photophobia), 27.22 ( pain ), 10.54 (visual acuity), 188.21 (F1) ,261.76 (BUT) ,269.05 (SⅠT) ;P<0. 05]. Those of middle and severe dry eye subgroup of control group hadn't significantly been improved at 28 d after therapy: SMD=0.10 (visual tiredness) ,0.16 (dry and unsmooth sensation) ,0.09 (foreign body sensation) ,0.38 ( burning sensation ), 0.24(photophobia) ,0.36 (pain) ,0.23 (red eye) ; MD=0.10 (visual acuity) ,0.50(F1) ,0.50(BUT), 0.50(SⅠT) [F=1.76 (visual tiredness), 1.61 (dry and unsmooth sensation), 1.02 (foreign body sensation),2.39 (burning sensation), 2.42 (photophobia), 2.73 ( pain ), 2.55 ( red eye ), 1.46 ( visual acuity) ,2.35 (F1) ,2.90 (BUT) ,2.76 (SⅠT) ; P>0.05]. SⅠT of anethol trithione group had been improved more significantly after therapy (F=13.77, P<0.05). Conclusion Anethol trithione could significantly improve middle and severe dry eye patients' symptoms and signs whose lacrimal gland function survival and it has clinical application value.     

L-肌肽对大鼠硒性白内障的影响

Objective To explore the effect of L-canosine in preventing and treating rat cataract induced by sodium selenite. Methods This was an experimental study. Cataract was induced in the rats by sodium selenite. Rats were divided into 3 groups and each group has 3 ones. L-canosine eye drops (50 g/L or 20 g/L) and 0.9% normal saline were respectively instilled to the rat eye for 3 weeks and examined. L-canosine was added to the medium of cultured rat cataract lens at 1.00, 0.10 and 0.01 g/L for 1 week and then examined. Cataract lens were studied by using two-dimensional eletrophoresis. Results One week after instillation of L-canosine, the scores of rat cataract were 2.22±0.65, 2.39±0.98 and 2.83±0.38 in 50 g/L, 20 g/L L-canosine and control groups, respectively. The lesion in 50 g/l, L-canosine group was lighter than that of the control group. There was significant difference between these two groups (P=0.013). On the 2nd and 3rd weeks, there was no difference among these three groups. After 1 week for culturing cataract lens, there was no difference between these three groups. The results of two-dimensional eletrophoresis showed that the protein number was 182 and 161 in the L-carnosine and control groups, respectively. High molecular weight protein decreased and low molecular weight protein increased in L-carnosine group. Conclusions L-carnosine at 50 g/L could restrain the development of early stage rat cataract. L-camosine could modulate the rat lens protein in vitro, but could not affect lens cataract scores.