腹腔镜与开腹子宫肌瘤剔除术186例临床分析

目的:比较腹腔镜与开腹子宫肌瘤剔除术的手术效果,探讨腹腔镜下子宫肌瘤剔除术的适应症、并发症及微创性。方法:分析92例腹腔镜下子宫肌瘤剔除术及94例开腹子宫肌瘤剔除术的临床资料,两组进行比较。结果:腹腔镜下子宫肌瘤剔除术组手术时间、术中发现盆腔粘连范围、粘连程度均高于开腹组,腹腔镜下子宫肌瘤剔除术组剔除直径大于10cm的肌瘤个数、子宫创面缝合例数少于开腹组,差异有统计学意义(P<0·05);两种术式术后住院天数、恢复生活自理时间、恢复工作时间、使用止痛泵及发热情况腹腔镜组均低于开腹组,差异有统计学意义(P<0·05);术后随访病例110例,随访时间1～5年,肌瘤复发两组比较差异无统计学意义(P>0·05)。结论:腹腔镜下子宫肌瘤剔除术具有创伤小、恢复快、治疗时间短及安全的优点,但此术式需要良好的手术技巧,并且选择手术适应症是治疗成功的关键。     

MRI阴性而PET阳性的颞叶癫痫:一组可应用手术治疗的症候群

多数非颞叶损害性癫痫(NLTLE)患者可通过高分辨率MRI发现其海马硬化(HS)。但是,也有少数NLTLE患者在电生理与临床上均表现为一侧颞叶癫痫,而MRI却无HS的证据。许多具有类似情况的患者经过18F-FDG-PET检查可发现相应的低代谢病灶,其病理生理机制尚不清楚。本研究旨在明确MRI未显示HS的NLTLE患者与那些MRI显示HS的NLTLE患者相比时是否表现出不同的临床病理学症候群。对30例伴有单侧EEG改变但MRI未显示HS的NLTLE患者(HS-veTLE)与30例年龄、性别匹配的伴有单侧EEG改变及MRI显示HS的NLTLE患者(HS+veTLE),在临…     

基层医院医患沟通技巧

作为工作在基层医院的医护工作者，掌握一些医患沟通技巧，对医院的长远发展和个人业务的开展都是十分必要的。现就本院的实际情况，发表一下个人观点。     

主体性语篇教学模式教改实验

自语法翻译法问世以来 ,人们在经历了一个多世纪的外语教学法探索后 ,由注重外因的教学法转移到了重视内因教学法的研究 ,即教学法的研究重点从重视教师转移到了重视学习者。而目前的研究往往重视了学习者的因素 ,却忽视了教师的因素 ,在实践中许多大学英语教师还是奉行“教师至上”的原则或是放任学生进行自学。笔者认为以上做法有失偏颇 ,并尝试主体性语篇教学模式进行教学。它融合教师的主导作用与学生的主体性 ,充分发挥学生自主学习的积极性 ,通过教师的联想式的语篇教学模式 ,使学生学会学习 ,进而想学 ,乐学 ,构建自己的学习和知识体…     

Rosiglitazone down-regulates lipopolysaccharide-induced expression of CD40 and intercellular adhesion molecule 1 in rat peritoneal mesothelial cells through a NF-κB dependent mechanism

Objective To investigate the effect and mechanism by which PPARγ ligand, rosiglitasone, regulates the expression of CD40 and intercellular adhesion molecule 1 (ICAM-1) in the rat peritoneal mesothelial cells (RPMCs) induced by lipopolysaccharide (LPS). Methods RPMCs were harvested from Sprague-Dawley rat peritoneal cavity and maintained under defined in vitro conditions. The cells were randomly divided into groups as follows: medium, LPS (5 mg/L), LPS (5 mg/L)+BAY11-7085(5 μmol/L, NF-κB inhibitor), rosiglitazone (10 μmol/L or 20 μmol/L, peroxisome proliferator-activated receptor γ activator), LPS (5 mg/L)+rosiglitazone (10 μmol/L)+GW9662 (3 μmol/L, peroxisome proliferator-aetivatcd receptor γ antagonist), and LPS (5 mg/L)+vehicle (DMSO 0.2 ml/L). The expressions of CD40 and ICAM-1 RNA in RPMCs were examined by RT-PCR after 3 hour treatment, and the protein expressions of CD40, ICAM-1, p-NF-κB p65 and p-IκBα were examined by Western blot or immunofluorescence after 24 hour treatment. Results Following treatment with LPS, both the expressions of CD40 and ICAM-1 protein in RPMCs were up-regulated significantly (P<0.05), and the phosphoralation of p65 was increased greatly (1.10±0.17 vs 0.55±0.06, P<0.05). BAY11-7085 (5 μmol/L) significantly decreased the protein expression of p-p65 (0.22±0.11 vs 1.10±0.17, P<0.01), CD40 (0.34±0.02 vs 0.50±0.06, P<0.05) and ICAM-1 (0.35±0.16 vs 0.74±0.03, P<0.05). Pretreated with rosiglitazone for 3 h then added with LPS for 1 h, the levels of p-p65, CD40 and ICAM-1 in RPMCs were significantly decreased compared with those of LPS group (0.77±0.08 vs 0.90±0.10, P相似文献   

肾病综合征并发乳糜腹水2例报告

肾病综合征是临床常见的肾脏疾病,可并发乳糜腹水[1],但报道并不多.我们在临床中遇到2例,现报道如下.     

近视眼的屈光度、眼轴、角膜屈光力的相关性探讨

目的：探讨近视眼的屈光度、眼轴、角膜屈光力之间的相关关系以及近视的成因。方法：将204例(348只眼)近视患者分为三组：低度近视组62眼(屈光度＜-3．0D）；中度近视组159眼(屈光度-3．0D～-6．0D)；高度近视组127眼(屈光度＞-6．0D)。测量患者眼的屈光度、角膜屈光力及眼轴，与近视程度、角膜屈光力、眼轴的关系。结果：在低度近视组，62只眼屈光度与眼轴长度无显著相关性，而屈光度与角膜水平径、垂直径屈光力呈正相关(P＜0．05)，相关具有显著性；在中度近视组和高度近视组屈光度与眼轴长呈正相关(P＜0．05)，相关具有显著性，且随近视度数的增加，与眼轴长的相关系数呈递增趋势，而中、高度组患者眼屈光度与角膜水平径及垂直径屈光力无显著相关性。结论：在近视性屈光不正的影响因素中，低度近视眼患者受角膜屈光力的影响相对较大，而眼轴的作用甚微；在中、高度近视眼患者中，眼轴长是影响近视程度的主要因素，而角膜屈光力几乎不起作用。     

检测血清VEGF、CEA、TSGF在肿瘤中的临床意义

目的研究血清VEGF、CEA在肿瘤诊断中联合应用价值以及肿瘤患者中血清VEGF与TSGF相关性.方法收集结直肠癌、肺癌患者以及正常人静脉血标本,ELISA法检测血清VEGF含量,放射免疫法检测CEA,化学显色法检测TSGF.结果结直肠癌患者中,血清CEA阳性率为32.4%,VEGF阳性率为54.1%,两者联合应用时阳性率为73.0%.血清VEGF与TSCF在结直肠癌中的相关系数为r=0.355(P＜0.01),肺癌患者中为r=0.612(P＜0.05).结论联合检测CEA和VEGF可以明显提高结直肠癌患者的阳性率,肿瘤患者血清中VEGF与TSGF的含量显著相关.     

鼻窦内窥镜治疗慢性鼻窦炎316例

近年来 ,鼻窦内窥镜手术治疗慢性鼻窦炎、鼻息肉取得很好的疗效 ,而鼻窦内窥镜术后及时处理手术成功关系密切。我科 1 999年 3月～ 2 0 0 1年 6月接受鼻窦内窥镜术 31 6例术后随访 2 5 4例 ,取得了一定的疗效。1　临床资料1 .1　一般资料　 31 6例中 ,男 1 86例 ,女 1 30例 ,年龄 1 0～ 70岁 ,平均 34.5岁。双侧鼻窦炎 2 2 8例 ,单侧鼻窦炎 88例 ,伴有鼻息肉 1 37例。均有鼻塞流涕 ,部分有头痛、头昏、嗅觉减退等症状 ,鼻腔内可见中鼻道引流不畅 ,中鼻道有脓涕和 (或 )息肉样新生物。按照中华耳鼻咽喉科学会慢性鼻窦炎鼻息肉分型分期标准 [1…     

MICROVASCULAR DECOMPRESSION FOR HEMIFACIAL SPASM - TECHNICAL NOTES AND COMPLICATION PREVENTION : EXPERIENCE OF 338 CASES

Objective To summarize our clinical experience of microvascular decompression (MVD)for medically intractable hemifacial spasm(HFS) patients with emphasis on microsurgical manipulation and to improve cure rate and avoid surgical complications. Methods Three hundred and thirty-eight patients with HFS underwent MVD under general anesthesia . With the help of "zero retraction" technique, prosthesis can be properly inserted between offending vessel loop and affected facial nerve REZ in a "rolling ball" fashion under operative microscope. Results Surgical intervention achieved high relief rate of 91 .4% and no major complications, with low recurrence rate of only 3.2% after averaging more than two years' follow-up ( M = 32 months). Conclusion It is possible to approach to the facial nerve REZ with "zero retraction", which is fundamentally important to clear from cranial nerve and cerebellar injury. Skilled microsurgical technique along with correct recognition and mobilization of offending vessels are a must