AQP8在胰腺导管腺癌中的表达及其临床意义

目的 研究水通道蛋白8(AQP8)在胰腺导管腺癌癌组织(PC)、癌旁正常胰腺组织(Non-PC)中的表达及其临床意义.方法 通过免疫组织化学(IHC)方法检测AQP8在 87例胰腺导管腺癌患者配对的石蜡包埋PC、Non-PC中的表达,并对AQP8的表达与胰腺导管腺癌患者临床资料间的关系进行分析.同时利用实时荧光定量PCR(qRT-PCR)及 Western blot方法各检测10例配对新鲜冻存PC、Non-PC中 AQP8的表达.结果 IHC显示AQP8主要表达于PC导管细胞的细胞质中,AQP8在PC组中的阳性表达率为79. 31％(69/87),而Non-PC组阳性表达率为18. 39％(16/87),两组阳性表达差异有统计学意义(P<0.001), AQP8的表达与肿瘤瘤体直径(P<0. 001)、分化程度(P<0. 001)、淋巴结的转移(P<0.001)以及TNM分期(P<0. 001)有显著相关性. qRT-PCR 及 Western blot 显示 PC 组中 AQP8 mRNA 及其蛋白表达量均显著高于配对的Non-PC组,两组间差异有统计学意义(P<0. 01<0. 001).结论 AQP8的表达与胰腺导管腺癌的瘤体直径、分化程度、淋巴结的转移以及TNM分期均有显著相关性,AQP8的检测有助于胰腺导管腺癌患者病情严重程度评估.     

早期股骨头缺血性坏死的MRI诊断价值

目的 探讨低场MRI在诊断早期股骨头缺血性坏死(ANFH)的价值.方法 回顾性分析经临床确诊的40例53个股骨头早期缺血坏死的X线、CT、低场MRI影像学表现.结果 53个早期ANFH中,X线平片显示:32个正常,21个有骨质改变,表现为骨质疏松及骨硬化.CT显示:13个正常,24个表现为星芒状结构变形、骨疏松和皮质变薄,16个表现为轻度骨硬化和小囊状透亮区.MRI显示:3个正常,50个有异常信号,其中表现为T1WI斑点状低信号22个,T1WI、T2WI序列上斑片状或不规则形低、等、高混杂信号28个,23髋出现典型"双线征".结论 低场MRI可以更准确显示早期股骨头缺血坏死病变,对股骨头缺血坏死的早期诊断具有重要意义.     

多种透明敷贴潮气通透率的实验研究

Background Transparent dressings have been common dressings used for Central Venous Catheter now. However, some authors indicated that they will cause insufficient moisture vapor transmission to a certain degree, which will result in local moistness that will promote the growth of bacteria on skin and around catheter. We compared the moisture vapor transmission rates(MVTR) between different dressings, including transparent and traditional gauze dressings which are used in the current catheter clinical nursing to seek for the ideal high moisture vapor transmission rates dressings in different humidity, and provide theoretical basis for clinical application and research.. Methods: 50 ml plastic centrifuge tubes added with 20 ml deionized water were divided into five groups according the dressings used to seal off the tubes. Group 1 was covered by 12 layers of ordinary gauze, group 2 by IV3000, group 3 by OPSITE FLEXIGRID, group 4 by 3M HP TegadermTM and group 5 by 3M TegadermTM. We put the tubes of 5 groups up straight into Rxz intellectual artificial climate culture cabinet, so that the dressings would not touch the water to simulate the situation that medical dressings contact with the normal skin. And test the average moisture vapor transmission rates (MVTR) of every dressing under different experiment condition. Then we put the tubes of group 2,3,4 and 5 down straight, so that the dressings would touch the water to simulate the situation that medical dressings contact with the sweating skin or wounded skin with exudates, and test MVTR of every dressing under different experiment condition. We also calculated dressings’ self reactive ability by comparing its MVTR tested when the dressings contacted water surface and that tested when did not contact water surface. Results: Among the five groups, the best moisture vapor transmission rates is group 1, followed by group 2, group 4, group 3 and group 5 when simulate the situation that medical dressings contact with the normal skin at the temperature and humidity condition: 20℃/30%, 20℃/60%, 20℃/90%, 30℃/30%,30℃/60% and 30℃/90% respectively. With the environmental relative humidity increased, the moisture vapor transmission rates decreased gradually. Between different dressings or humidity conditions, the statistical analysis of the moisture vapor transmission rates in different groups were significantly different (P <0.01);In high temperature (37 ℃), high humidity (90%), the transparent dressings’ MVTR of group 2 is obviously superior to group 1, the difference was significant (P <0.01). Among the different dressings, the dressings’ own reactive moisture vapor transmission rates of group 2 is the best up to 10.2～16.3 times, that of group 4 is listed second, up to 2.6～9.6 times. Conclusions: Environmental humidity and temperature have great influence on different dressings’ MVTR. Some transparent dressing, group 2 in this study has quite ideal MVTR as ordinary gauze. So, we should not care about the increased infection rate caused by low moisture vapor transmission rates, which was put forward by other authors before. The impact of its clinical practice on catheter-related infections should be further confirmed by multi-center observation.     

烧伤休克期患者液体复苏中羟乙基淀粉的应用

中分子羟乙基淀粉130/0.4(万汶)为第3代人造胶体,维持胶体渗透压的疗效与血浆相近,在烧伤休克早期救治中得到广泛应用.近年我们在临床实际研究中发现,应用万汶虽然有助于患者平稳度过休克期,但由于万汶不含蛋白成分,不能及时补充烧伤患者休克期蛋白的丢失,可导致患者血清蛋白偏低而不利于后期的治疗.基于此我们进一步开展了不同程度烧伤患者休克前期液体复苏治疗中应用万汶的疗效及血清蛋白变化的研究,以期为万汶临床适应证的选择提供依据.     

银屑病关节炎32例报告

银屑病关节炎是一种与银屑病(牛皮癣)有关的炎性关节病,病理改变主要为炎性滑膜炎,病程迁延,易复发,晚期可出现关节强直而致残.我国1984年的调查,银屑病的发病率为1.23%,银屑病关节炎仅占银屑病的0.69%,更为少见[1],常易误诊.我院1997年9月～1999年6月诊治的32例银屑病关节炎中28例曾误诊,误诊率87.5%.现就其临床表现及误诊情况报道如下.     

多层螺旋CT诊断超急性期脑梗死的价值

目的 分析超急性期脑梗死多层螺旋CT平扫表现,以提高超急性期脑梗死的诊断率.方法 确诊为超急性期脑梗死的患者42例,回顾分析多层螺旋首次CT平扫征象.结果 CT表现基本正常5例,显示脑实质密度降低影33例,可见局部脑组织肿胀征22例,可见一侧大脑中动脉高密度影11例.首次诊断为超急性脑梗死31例(符合率74.0%),可...     

TFPI-2基因CpG岛甲基化与胰腺癌的关系

目的:检测胰腺癌组织组织因子途径抑制物-2(TFPI-2)基因CpG岛甲基化的状态,并分析甲基化改变与胰腺癌的关系。方法:应用甲基化特异性聚合酶链反应(MSP)检测45例胰腺癌组织、相应癌旁组织中TFPI-2基因的甲基化状态。结果:胰腺癌组织中TFPI-2基因的甲基化阳性率为71.1%(32/45),明显高于癌旁组织的31.1%(14/45)(P<0.01)。8例正常胰腺组织中均未发生甲基化。TFPI-2基因甲基化阳性率还与胰腺癌的临床分期、组织分化程度、肿瘤直径有相关性(P<0.05)。结论:TFPI-2基因在胰腺癌组织中出现异常甲基化,可能与胰腺癌的发生发展关系密切。     

巨大子宫肌瘤13例低场强MRI分析

目的探讨巨大子宫肌瘤的低场强MRI表现,提高MRI的诊断水平。方法回顾性分析经病理证实的13例巨大子宫肌瘤患者,矢状位、冠状位、轴位的T1WI、T2WI、STIR序列的扫描等MRI表现,并与病理对照。结果肿瘤最大直径16～25cm10例,30cm以上3例;手术证实发生于浆膜下8例,肌壁间型4例,黏膜下型1例;所有病例T1WI均为等低信号,T2WI和STIR序列上病灶内可见斑片状高信号,其中2例病理证实有钙化。结论低场强MRI能够清楚显示子宫肌瘤的位置、大小及与周围的关系,对肿块内发生坏死等病理变化亦有一定的提示,对临床手术治疗具有重要价值。     

奎硫平治疗躁狂症对照研究临床疗效的Meta分析

目的评价奎硫平治疗躁狂症的疗效以及与对照组间的差异。方法应用循证医学方法对符合标准的15项研究进行分析,评价奎硫平与对照组治疗躁狂症的有效率、痊愈率的差异。结果奎硫平组与安慰剂的3周、12周有效率有非常显著性差异(P<0.01),3周、12周痊愈率同样存在非常显著性差异(P<0.01)。在应用心境稳定剂的基础上与安慰剂的对照比较也发现,3周和6周的有效率与痊愈率均非常显著高于安慰剂组(P<0.01),但是与传统抗精神病药物、氯氮平以及心境稳定剂的有效率、痊愈率以及症状改善率均没有显著性差异(P>0.05)。结论奎硫平治疗躁狂症是一种良好的药物,联合心境稳定剂效果更好。