华支睾吸虫感染的超声诊断分析

【提要】 回顾性分析临床确诊有华支睾吸虫感染的214例患者治疗前后的超声表现，结果感染后的超声表现以胆囊及胆管病变为主，胆囊内出现的絮状弱回声漂浮物具有特征性，治疗后该漂浮物消失。绝大多数患者有胆管回声改变，表现为胆管壁增厚、毛糙，回声增强，治疗后恢复较慢。超声对该病的诊断有应用价值。     

大肠息肉部位、大小、形态等与病理分型的关系

目的探讨大肠息肉部位、大小、形态、数目部与病理类型的关系。方法经结肠镜检查诊断200例结肠息肉情况与病理检查进行分析。结果在≤1cm的息肉中以炎性息内较多见，在〉lcm的息肉中以腺瘤性息肉较多见。息肉恶变均发生在1cm以上，尤其是〉2cm的息肉。在有蒂息肉中以炎性较多见，均为良性，无蒂息肉中以腺瘤性较多见。最常发生于直肠和乙状结肠的息肉以炎性较多见；近端结肠的息肉，腺瘤性相对较多。单发息肉中多数是炎性息肉，多发息肉中多数是腺瘤性息肉。结论大肠息肉的部位和大小与病理类型有关。     

Prospective cohort comparison of flavonoid treatment in patients with resected colorectal cancer to prevent recurrence

AIM： To investigate biological prevention with flavonoids the recurrence risk of neoplasia was studied in patients with resected colorectal cancer and after adenoma polypectomy. METHODS： Eighty-seven patients, 36 patients with resected colon cancer and 51 patients after polypectomy, were divided into 2 groups： one group was treated with a flavonoid mixture （daily standard dose 20 mg apigenin and 20 mg epigallocathechin-gallat, n = 31） and compared with a matched control group （n = 56）. Both groups were observed for 3-4 years by surveillance colonoscopy and by questionnaire. RESULTS： Of 87 patients enrolled in this study, 36 had resected colon cancer and 29 of these patients had surveillance colonoscopy. Among the flavonoid-treated patients with resected colon cancer （n = 14）, there was no cancer recurrence and one adenoma developed. In contrast the cancer recurrence rate of the 15 matched untreated controls was 20% （3 of 15） and adenomas evolved in 4 of those patients （27%）. The combined recurrence rate for neoplasia was 7% （1 of 14） in the treated patients and 47% （7 of 15） in the controls （P = 0.027）. CONCLUSION： Sustained long-term treatment with a flavonoid mixture could reduce the recurrence rate of colon neoplasia in patients with resected colon cancer.     

儿童结直肠息肉的临床特征

结直肠息肉是儿童常见病,是儿童无痛性便血的常见病因。随着儿童结肠镜检查技术的推广,越来越多的结直肠息肉患儿得到了诊断和治疗。结直肠息肉多在幼儿期、学龄前期出现症状,通过结肠镜检查,能够确认息肉的部位、大小、数量,能够进行病理检查确定其性质。儿童结直肠息肉有炎性息肉、错构瘤性息肉、腺瘤性息肉等多种类型。儿科医生需要提高认识,对有症状或有相关家族史的患儿积极进行结肠镜检查。     

CD147和MMP-2在胆囊癌组织中的表达及意义

【目的】探讨细胞外基质金属蛋白酶诱导因子（CD147）和基质金属蛋白酶2（MMP‐2）在胆囊癌组织中的表达及意义。【方法】采用免疫组织化学法检测30例慢性胆囊炎和21例胆囊癌患者组织中CD147和M M P‐2的表达,并分析其临床意义。【结果】21例胆囊癌组织中 CD147和 M M P‐2的阳性表达率分别为71．4％（15／21）和76．2％（16／21）,显著高于慢性胆囊炎组织中的表达13．3％（4／30）和23．3％（7／30）（ P ＜0．01）;CD147和M M P‐2的阳性表达与胆囊癌的临床分期和淋巴结转移显著相关（ P ＜0．05）,且胆囊癌中CD147与MMP‐2的阳性表达呈正相关（ r ＝0．631,P ＝0．002）。【结论】CD147和MMP‐2在胆囊癌组织中的阳性表达与其临床分期和淋巴结转移相关,CD147可能通过与M M P‐2的相互作用共同参与调控胆囊癌的进展与转移。     

Does aspirin-induced oxidative stress cause asthma exacerbation?

Aspirin-induced asthma (AIA) is a distinct clinical syndrome characterized by severe asthma exacerbations after ingestion of aspirin or other non-steroidal anti-inflammatory drugs. The exact pathomechanism of AIA remains unknown, though ongoing research has shed some light. Recently, more and more attention has been focused on the role of aspirin in the induction of oxidative stress, especially in cancer cell systems. However, it has not excluded the similar action of aspirin in other inflammatory disorders such as asthma. Moreover, increased levels of 8-isoprostanes, reliable biomarkers of oxidative stress in expired breath condensate in steroid-naïve patients with AIA compared to AIA patients treated with steroids and healthy volunteers, has been observed. This review is an attempt to cover aspirin-induced oxidative stress action in AIA and to suggest a possible related pathomechanism.     

阑尾管状绒毛状腺瘤临床特征、内镜特点及文献复习

阑尾肿瘤临床上十分少见，占胃肠道肿瘤的0．4％。尤其是发生于阑尾的管状绒毛状腺瘤在临床上属少见病，具有癌变潜能由于本病症状不典型或无明显临床症状，特别是电子肠镜下特点总结较少，故常导致临床漏诊及误诊，为加深对本病的认识和了解，我们收集浙江中医药大学附属第一医院近年收治的阑尾管状绒毛状腺瘤患者2例，对其临床症状、病理基础和肠镜下表现进行总结分析，并进行文献复习。     

涡阳县人民医院实施胆囊结石腹腔镜胆囊切除术临床路径效果分析

目的 评价胆囊结石腹腔镜胆囊切除术临床路径的临床应用效果.方法 将涡阳县人民医院2013年3月至2014年11月实施临床路径管理的259例胆囊结石腹腔镜胆囊切除术患者纳为路径组,未实施临床路径管理的256例胆囊结石腹腔镜胆囊切除术患者纳为对照组,对两组患者的平均住院天数、手术前住院天数、住院费用、药品费用、检查费用、药品费用比例、术后并发症率和患者满意度等指标进行比较评价.结果 路径组平均住院天数为(5.3±1.6)d,手术前住院天数为(1.2±0.4)d,与对照组比较,差异有统计学意义(P<0.05);路径组较对照组的住院费用和检查费增加,药品费用减少,差异有统计学意义(P<0.05).术后随访,路径组患者满意度高于对照组,差异有统计学意义(P<0.05);两组术后并发症差异无统计学意义(P>0.05).结论 胆囊结石腹腔镜胆囊切除术临床路径的实施可以有效缩短住院时间,降低治疗费用,减轻患者经济负担,提高患者满意度,对提升医院社会和经济效益有着积极意义.