螺旋CT虚拟内诊镜在小儿气管支气管异物诊断中的应用

目的探讨螺旋CT虚拟内诊镜(CTVE)在小儿气管、支气管异物诊断上的应用价值。 方法回顾性分析东南大学医学院附属徐州医院1998年1月至2004年12月收治的121例术前经CTVE诊断为气管支气管异物，并行支气管镜探查术患儿的诊疗情况，并分析CTVE诊断在临床应用上的意义及诊断的阳性符合率。 结果121例经CTVE诊断并行支气管镜探查证实并取除异物者115例，诊断符合率9504%。 结论CTVE检查是目前无创非侵入性诊断小儿气管支气管异物的较理想方法。     

<Emphasis Type="Italic">Acinetobacter baumannii</Emphasis> bacteraemia in patients with haematological malignancy: a multicentre retrospective study from the Infection Working Party of Jiangsu Society of Hematology

Acinetobacter baumannii (Ab) bacteraemia in patients with haematological malignancies is fatal but rarely reported. We explored the clinical characteristics, drug resistances and prognostic factors in these patients. This multicentre, retrospective study was conducted at the department of haematology wards of 18 tertiary hospitals in China from January 2014 to June 2015. The total clinical isolates from every source were collected from patients with haematological malignancy. Haematological malignancy patients diagnosed with Ab bacteraemia were analysed. During the study period, 40 patients with Ab bacteraemia were identified, accounting for 2.9% (40/1358) of bacteraemia cases, of which 25 (62.5%) had acute leukaemia (AL) and 27 (67.5%) had neutropaenia. Compared with non-neutropaenic patients, neutropaenic patients showed higher Acute Physiology and Chronic Health Evaluation (APACHE) scores and 30-day mortality rates (p?<?0.05). The in vitro antibiotic susceptibility of Ab to colistin was highest, at 100%, followed by that of tigecycline (91.30%) and amikacin (75.86%). Compared with the patients who had carbapenem-susceptible Ab infections, patients infected with carbapenem-resistant Ab (CRAB) had significantly longer hospital stays and were more likely to have had exposure to carbapenem before bacteraemia (p?<?0.05). The 30-day mortality rate was 32.5%. CRAB, neutropaenia, higher APACHE score, Pitt bacteraemia score and inappropriate initial antimicrobial therapy were significantly associated with 30-day mortality. Multivariable analysis showed that APACHE score and CRAB were independent predictors of 30-day mortality. Haematologic patients with AL and febrile neutropaenia were at high risk of Ab bacteraemia. More attention should be paid to CRAB, which is an independent risk factor for mortality in haematological malignancy patients with Ab bacteraemia.     

双调控溶瘤腺病毒携带SEA基因靶向鼠膀胱癌的表达

目的:研究hTERT和HIF启动子双调控的溶瘤腺病毒能否感染鼠膀胱癌细胞并表达治疗基因,为动物实验提供依据.方法:以不同浓度溶瘤腺病毒感染鼠膀胱癌细胞,生物倒置显微镜下动态观察细胞形态变化,RT-PCR检测SEA在细胞内mRNA表达,Western blot检测SEA蛋白表达.结果:镜下可见细胞感染腺病毒并最终裂解,RT-PCR和Western blot分别检测到实验组mRNA和蛋白的表达.结论:携带SEA基因的hTERT/HIF双调控溶瘤腺病毒可在鼠膀胱癌细胞内复制增殖并表达SEA基因,可用于治疗鼠膀胱癌的动物实验研究.     

盐酸羟考酮缓释片不同给药途径治疗中重度癌痛的临床观察

目的:比较盐酸羟考酮缓释片直肠给药与口服给药两种途径治疗癌痛的临床疗效和不良反应。方法:选择2015年1月至2016年6月在勉县医院肿瘤血液科治疗的68例癌症伴有中、重度疼痛患者,随机分为观察组34例和对照组34例,两组患者均给予盐酸羟考酮缓释片进行治疗,观察组采用直肠给药,对照组采用口服给药。观察比较两组患者用药后缓解疼痛的疗效、患者生活质量的改善以及不良反应的发生情况。结果:观察组和对照组用药后的止痛有效率分别为85.3%和88.2%,两组1 h、12 h、1周、2周的NRS评分及疼痛缓解有效率比较差异均无统计学意义(P＞0.05);观察组和对照组KPS的改善率分别为91.2%和88.2%,差异亦无统计学意义(P＞0.05);但观察组便秘发生率(17.6%)和恶心呕吐发生率(11.8%)明显低于对照组（41.2%和26.5%）,差异均有统计学意义(P＜0.05)。结论:对中重度癌痛患者使用盐酸羟考酮缓释片经直肠途径给药与口服给药相比,具有相同的镇痛效果,但便秘和恶心呕吐的不良反应发生率明显减少。     

痰热清注射液联合孟鲁司特对阻塞性睡眠呼吸暂停综合征患儿血清ET 1 AngⅡ及leptin的影响

【摘要】 目的 探讨痰热清注射液联合孟鲁司特对阻塞性睡眠呼吸暂停综合征(OSAS)患儿血清ET 1、AngⅡ、leptin的影响。方法 选择2013年6月~2015年8月收治的阻塞性睡眠呼吸暂停综合征患儿88例为研究对象,按抽签法随机分为对照组和实验组各44例。所有入选患儿均接受常规治疗,在此基础上,对照组患者给予痰热清注射液治疗,实验组基于对照组加孟鲁司特进行联合治疗。比较两组临床疗效,治疗前后LSaO2、MSaO2、AHI、TS90%,血清ET 1、AngⅡ及leptin的改变情况。结果 治疗后,实验组有效率（9545%）高于对照组（7273%）（P＜005）。两组AHI、TS90%,血清ET 1、AngⅡ、leptin均显著下降,且实验组明显低于对照组（P＜005）。两组LSaO2、MSaO2均有明显上升,且实验组高于对照组（P＜005）。结论 痰热清注射液联合孟鲁司特对阻塞性睡眠呼吸暂停综合征患儿的治疗效果肯定,能够有效降低血清ET 1、AngⅡ及leptin水平。     

An unusual ultrasonographic appearance of a uterine leiomyoma micking an ovarian mass

Uterine leiomyoma is the most common benign uterine tumour. Two thirds of leiomyomata undergo degeneration, 4% of which are cystic. We present a case with an unusual parametrial ultrasonographic cystic finding, thought to be of ovarian pathology, which was in fact a leiomyoma with cystic degeneration.     

The Reliability and Validity of Post Stroke Depression Scale in Different Type of Post Stroke Depression Patients

ObjectiveA self-rating post stroke depression scale (PSDS) showed a good reliability and validity to assess severity of depressive symptoms among stroke patients. This study aimed to retest the psychometric properties of PSDS in different types of post-stroke depression (PSD).Materials and methodsA total of 170 stroke patients were recruited in the study. 82 and 25 patients were respectively diagnosed as PSD symptoms disorder (PSDSD) and PSD disorder (PSDD) patients according to their respective diagnostic criteria. The PSDS and the 9-item Patient Health Questionnaire (PHQ-9) were used to assess the severity of depression. Cronbach α, Spearman rank coefficient and independent sample t-test were conducted to examine reliability, internal consistency and discriminate validity. Then the receiver operating characteristic curve and Youden index were used to performance evaluation and cut-off value respectively in different subtypes of PSD patients.ResultsThe Cronbach α of PSDS was 0.857, indicting a good reliability. The Spearman correlation coefficient between PSDS and PHQ-9 was 0.942 (P<0.001). The discriminate validity displayed significant difference between PSDSD as well as PSDD and no depression patients (all P<0.001). 5/24 and 10/24 were the cut-off value for PSDSD and PSDD patients.ConclusionsPSDS is a useful screen tool with an acceptable psychometric properties for estimation of different subtypes of PSD patients.     

经皮肾镜治疗肾盂输尿管连接部狭窄106例临床研究

目的:探讨经皮肾镜下治疗肾盂输尿管连接部狭窄的临床效果。方法:对106例肾盂输尿管狭窄的患者予经皮肾镜直视下电钩切开肾盂输尿管狭窄环。结果:106例患者狭窄环均成功切开,并留置双J管,3个月后拔管复查显示肾盂积水和输尿管扩张消失或缓解。结论:经皮肾镜下电钩切开肾盂输尿管狭窄环,可有效地解决肾盂积水所致肾功能损害和腰痛,且易被患者接受,特别对于手术后再次狭窄的患者,是一种行之有效的微创治疗方法。     

Zinc protoporphyrin IX enhances chemotherapeutic response of hepatoma cells to cisplatin

AIM: To investigate the effect of zinc protoporphyrin IX on the response of hepatoma cells to cisplatin and the possible mechanism involved.METHODS: Cytotoxicity was determined using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. Apoptosis was determined by a flow cytometric assay. Western blotting was used to measure protein expression. Heme oxygenase (HO)-1 activity was measured by determining the level of bilirubin generated in isolated microsomes. Reactive oxygen species (ROS) production was monitored by flow cytometry. Caspase-3 activity was measured with a colorimetric assay kit. Mice were inoculated with 1 × 10⁷ tumor cells subcutaneously into the right flanks. All mice were sacrificed 6 wk after the first treatment and tumors were weighed and measured.RESULTS: Overexpression of HO-1 in HepG2 cell line was associated with increased chemoresistance to cis-diaminedichloroplatinum (cisplatin; CDDP) compared to other cell lines in vitro. Inhibition of HO-1 expression or activity by zinc protoporphyrin IX (ZnPP IX) markedly augmented CDDP-mediated cytotoxicity towards all liver cancer cell lines in vitro and in vivo. In contrast, induction of HO-1 with hemin increased resistance of tumor cells to CDDP-mediated cytotoxicity in vitro and in vivo. Furthermore, cells treated with ZnPP IX plus CDDP exhibited marked production of intracellular ROS and caspase-3 activity, which paralleled the incidence of cell apoptosis, whereas hemin decreased cellular ROS and caspase-3 activity induced by CDDP.CONCLUSION: ZnPP IX increases cellular sensitivity and susceptibility of liver cancer cell lines to CDDP and this may represent a mechanism of increasing ROS.