儿童手掌孤立性环状肉芽肿一例

<正>环状肉芽肿是慢性、良性且通常具有自限性的肉芽肿性皮肤病,典型的临床表现为好发于肢端的弧形或者环形斑块。临床上有不同的亚型,孤立性的皮损是局限型的少见类型。皮损通常发生于肢端的伸侧,很少发生于面部及手掌,手掌孤立性环状肉芽肿更少见。现报道1例发生于手掌的孤立性环状肉芽肿,并     

成人线状IgA大疱性皮病2例

报道2例成人线状IgA大疱性皮病。患者1,女,57岁。躯干、四肢红斑、水疱2个月,伴痒。皮肤科检查:躯干、四肢水肿性红斑,呈环形,部分边缘可见黄豆粒大水疱,疱液清,尼氏征阴性。患者2,女,43岁。躯干、四肢散发性水疱20天,伴痒。皮肤科检查:躯干、四肢绿豆至黄豆大水疱,疱液清,尼氏征阴性。两例患者组织病理检查均表现为:表皮下水疱,真皮乳头嗜中性粒细胞小脓肿;直接免疫荧光示:表皮基底膜带IgA线状沉积。     

桥本甲状腺炎的中医药治疗研究进展

桥本甲状腺炎(Hashimoto′s thyroiditis,HT)是一种与甲状腺有关的自身免疫性疾病,发病率在逐年增高。中医药治疗桥本甲状腺炎具有较大优势:缓解甲状腺肿大,降低甲状腺自身免疫性抗体、调节机体本身的免疫、延缓病情等。该研究对近年来桥本甲状腺炎的中医药治疗研究进展进行综述。     

不同种质金线莲氨基酸和矿物质元素量的比较

目的比较不同种质金线莲中氨基酸和矿物质元素的差异。方法采用全自动氨基酸分析仪和原子吸收光谱仪测定11个不同种质金线莲中氨基酸和矿物质元素的量。结果不同种质金线莲必需氨基酸为2.81%~4.47%,总氨基酸量为11.38%~17.06%,其中天门冬氨酸、谷氨酸和精氨酸的量明显高于其他氨基酸组分。矿物质元素中钾元素的量最高,其顺序为KCaMgFeMnZnCrCuPbCd。主成分分析表明丙氨酸、丝氨酸、谷氨酸、天门冬氨酸、苏氨酸、异亮氨酸、丙氨酸、苯丙氨酸、亮氨酸为金线莲的特征性氨基酸,Fe、Zn、Mn、Ca、Cr、Mg为金线莲的特征性元素。结论金线莲中氨基酸和矿物质元素量存在地域性差异。     

人多梳蛋白2和Ki67在鼻咽癌中的表达及预后意义

目的 检测人多梳蛋白2(HPC2)和Ki67在鼻咽癌组织中的表达,探讨其表达与临床病理因素的关系,揭示两者表达相关性及其预后意义。方法 采用Western blot法检测HPC2在鼻咽癌及非肿瘤鼻咽上皮组织中的表达,进一步选取126例鼻咽癌活检石蜡组织标本,免疫组化法检测HPC2和Ki67的表达情况,结合临床病理资料及随访数据统计分析。结果HPC2在鼻咽癌组织的表达较鼻咽非肿瘤组织的表达上调,HPC2和Ki67的蛋白表达均定位于鼻咽癌组织细胞核,HPC2高表达占55.6%,Ki67高表达占61.9%。HPC2的表达与鼻咽癌的TNM分期、复发、转移有关。HPC2和Ki67 的表达呈正相关(r=0.354,P<0.01)。HPC2和Ki67联合检测在NPC的无进展生存(PFS)和总生存(OS)的预后风险模型显示,两者均高表达者为高风险组,预后最差,两者表达不一致为中度风险,预后中等;如果两者均低表达为低度风险,预后最好(P=0.000)。结论HPC2高表达状态与鼻咽癌临床进展及预后不良有关,联合Ki67检测的预后模型有利于更准确地评估预后。     

腹腔镜胆囊切除术围手术期护理进展

自Mouret于1987年行第1例腹腔镜胆囊切除术(LC)以来,随着腹腔镜外科技术的不断进步,LC术作为经典手术已基本取代了开腹手术,成为胆囊切除的常规择期手术[1],因而其护理也日益重要,对患者做好心理护理,健康教育,充分的术前准备及术后悉心护理,预防和及时发现处理并发症,对促进患者术后尽快恢复有重要的作用,现就LC护理进展综述如下.     

增加容积数据单元重组间隔对全脑CT灌注成像参数值及辐射剂量的影响

脑CT灌注成像因能提供更多的血流动力学信息,在缺血性脑卒中的早期诊断及时间窗外溶栓治疗前脑组织病理生理评估中的价值逐渐得到肯定[1-2].随着320排容积CT的出现,由于其探测器宽度可达到16 cm,使全脑CT灌注成像成为可能,因而可提供更加全面的脑组织血流动力学信息,在发现病灶及评价缺血半暗带方面更加准确[3].但是不可忽视的是CT辐射剂量问题已逐渐引起大家的关注[4-5],如何最大程度控制CT灌注成像的辐射剂量将是制约容积CT灌注成像进一步发展的关键问题之一.     

Effect of total arch replacement combined with stent trunk on treating De Bakey type Ⅰ aortic dissection

Background Aortic dissection(AD) is a life-threatening surgical emergency. Total arch replacement combined with stent trunk has gradually become the standard procedure for De Bakey type Ⅰ AD in China, but the complication and mortality rates are still relatively high due to surgical technical difficulties and complexity. In principle, AD should be treated with emergency surgery once the diagnosis is confirmed, but the operation time varies greatly in China due to the restriction of medical conditions. Therefore, analyzing and comparing the surgical mortality and complications rate between acute and chronic phase may facilitate the clinicians to comprehensively evaluate the patient's condition, and thus select an appropriate operation timing. Methods A total of330 De Bakey type Ⅰ AD patients admitted and treated with total arch replacement combined with stent trunk procedure in Guangdong Cardiovascular Institute from Jan 2010 to Jan 2014 were retrospectively analyzed. According to whether the onset was longer than 2 w, patients were divided into acute phase group and chronic phase group. There were 231 cases in acute phase group(≤ 2 w), and the average length from onset to operation was 5.6± 3.8 d; while 99 cases in chronic phase group( 2 w), and the average length from onset to operation was 20.6 ±14.7 d. Results The total mortality rate was 13%. Acute renal failure, neurological dysfunction, and wound healing were the major complications after operation. The in-hospital morality rate was 16.0%(37/231) in the acute group, while 6.1 %(6/99) in the chronic group. The surgical data of the ratio of CABG, cardiopulmonary bypass(CPB) time, aortic cross clamp time, intra-operative RBC infusion were significant higher in the acute phase group(P 0.05). The postoperative data of ICU stay, mechanical ventilation time, the incidences of neurological dysfunction, CRRT-dependent acute renal failure, hepatic insufficiency, and poor wound healing were significant higher in the acute phase group(P 0.05). Conclusions The total arch replacement combined with stent trunk for De Bakey type Ⅰ aortic dissection is safe and effective. Patients in the acute phase show higher postoperative mortality and complications. The acute phase is associated with relatively higher risk of surgical treatment.     

顶空毛细管柱气相色谱法测定水中苯系物

目的建立一种用顶空毛细管柱气相色谱测定水中苯系物的方法。方法采用顶空法,当顶空瓶中苯系物在气液两相中达到动态平衡时,取顶部气体进样,经毛细管柱分离,氢火焰离子化检测器检测,保留时间定性,峰面积定量。结果当标准溶液浓度在一定范围内,线性相关系数r>0.999 1,其相对标准偏差为0.54%～2.09%,样品加标回收率98.5%～103.0%。结论顶空毛细管柱气相色谱测定水中苯系物,速度快,准确度高,重现性好,不需二硫化碳萃取,是测定水中苯系物较为理想的方法。     

类脂蛋白沉积症一例

正类脂蛋白沉积症是一种罕见的遗传性皮肤病,现将1例我院确诊的第2个家系的第3个类脂蛋白沉积症患者报道如下。临床资料患者,男,30岁。自幼声音嘶哑,1岁半时肘关节处出现丘疹,以后陆续在双手足、眼睑出现丘疹。4岁时因声音嘶哑查体发现扁桃体肥大而切除。15岁前曾出现光敏,18岁后自然消退。3年前发现临界高血压,定期测量血压,未用降压药物。父